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#1896 of 11K

Q0091

HCPCS Procedure Code

HCPCS code Q0091 is the #1,896 most-billed Medicaid procedure code, with $12.0M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $11.15. Costs vary widely — the 90th percentile is $30.86 per claim, 2.8× the median.

Total Paid

$12.0M

0.00% of all spending

Total Claims

1.1M

Providers

2,180

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for Q0091? Based on 1,561 providers billing this code nationally.

Median

$11.15

Average

$13.98

Std Dev

$12.69

Max

$100.44

Percentile Distribution (Cost per Claim)

p10
$0.84
p25
$3.51
Median
$11.15
p75
$21.83
p90
$30.86
p95
$37.50
p99
$49.58

50% of providers bill between $3.51 and $21.83 per claim for this code.

90% bill between $0.84 and $30.86.

Top 1% bill above $49.58.

About This Procedure

HCPCS code Q0091 was billed by 2,180 providers across 1.1M claims, totaling $12.0M in Medicaid payments from 2018–2024. This code was used for 1.0M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.15

Providers Billing

1,561

National Spending

$12.0M

Avg/Median Ratio

1.25×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for Q0091

#ProviderTotal Paid
11154355220$368K
21184780355$313K
3Pikeville Medical Center Inc

Pikeville, KY · General Acute Care Hospital

$293K
41942515440$171K
51124588793$170K
61942475793$167K
71245526987$166K
8Sun River Health Inc.

Peekskill, NY · Clinic/Center Federally Qualified Health Center (FQHC)

$154K
9Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$153K
101366418709$133K
111720367204$106K
121184610248$97K
131710050760$96K
141144399098$93K
151811226749$91K
161437161437$89K
171790021673$87K
181821021213$87K
191629057146$82K
201699733071$81K

Showing top 20 of 2,180 providers billing this code