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#4360 of 11K

P9011

HCPCS Procedure Code

HCPCS code P9011 is the #4,360 most-billed Medicaid procedure code, with $635K in payments across 40K claims from 2018–2024. The national median cost per claim is $2.78. Costs vary widely — the 90th percentile is $308.97 per claim, 111.1× the median.

Total Paid

$635K

0.00% of all spending

Total Claims

40K

Providers

31

Avg Cost/Claim

$16

National Cost Distribution

How much do providers bill per claim for P9011? Based on 31 providers billing this code nationally.

Median

$2.78

Average

$65.66

Std Dev

$119.18

Max

$372.37

Percentile Distribution (Cost per Claim)

p10
$0.48
p25
$1.03
Median
$2.78
p75
$65.91
p90
$308.97
p95
$336.14
p99
$366.80

50% of providers bill between $1.03 and $65.91 per claim for this code.

90% bill between $0.48 and $308.97.

Top 1% bill above $366.80.

About This Procedure

HCPCS code P9011 was billed by 31 providers across 40K claims, totaling $635K in Medicaid payments from 2018–2024. This code was used for 34K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$2.78

Providers Billing

31

National Spending

$635K

Avg/Median Ratio

23.62×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for P9011

#ProviderTotal Paid
11881626943$132K
2Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$119K
3Childrens Hospital Of Philadelphia

Philadelphia, PA · General Acute Care Hospital Children

$100K
4Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$68K
5Vhs Childrens Hospital Of Michigan Inc

Detroit, MI · Clinic/Center, Ambulatory Surgical

$67K
6State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$64K
71952546616$27K
8Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$9K
91699986331$8K
10Kern County Hospital Authority

Bakersfield, CA · General Acute Care Hospital

$7K
111003960139$5K
12Children's Health System Of Texas

Dallas, TX · General Acute Care Hospital Children

$5K
13Bakersfield Memorial Hospital

Bakersfield, CA · General Acute Care Hospital

$5K
14Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$4K
15Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$4K
161538157508$2K
171427176569$2K
181972534147$2K
191457341851$2K
201902846306$1K

Showing top 20 of 31 providers billing this code