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#3796 of 11K

H1011

HCPCS Procedure Code

HCPCS code H1011 is the #3,796 most-billed Medicaid procedure code, with $1.2M in payments across 19K claims from 2018–2024. The national median cost per claim is $47.19. Costs vary widely — the 90th percentile is $234.09 per claim, 5.0× the median.

Total Paid

$1.2M

0.00% of all spending

Total Claims

19K

Providers

64

Avg Cost/Claim

$62

National Cost Distribution

How much do providers bill per claim for H1011? Based on 61 providers billing this code nationally.

Median

$47.19

Average

$99.40

Std Dev

$153.99

Max

$889.64

Percentile Distribution (Cost per Claim)

p10
$21.43
p25
$28.23
Median
$47.19
p75
$93.38
p90
$234.09
p95
$268.07
p99
$832.86

50% of providers bill between $28.23 and $93.38 per claim for this code.

90% bill between $21.43 and $234.09.

Top 1% bill above $832.86.

About This Procedure

HCPCS code H1011 was billed by 64 providers across 19K claims, totaling $1.2M in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$47.19

Providers Billing

61

National Spending

$1.2M

Avg/Median Ratio

2.11×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for H1011

#ProviderTotal Paid
11720486228$145K
21124319892$120K
31033385828$102K
4County Of Riverside

Riverside, CA · Community/Behavioral Health

$82K
51073701033$62K
61184880924$62K
71033725684$54K
81821297276$50K
91477766905$49K
101285979757$40K
111356492532$33K
121912091018$28K
131285078949$28K
141871259770$25K
151083886022$24K
161699311894$24K
171043239320$23K
181700129491$20K
191306970652$14K
201023122967$13K

Showing top 20 of 64 providers billing this code