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#1572 of 11K

Q0138

HCPCS Procedure Code

HCPCS code Q0138 is the #1,572 most-billed Medicaid procedure code, with $18.8M in payments across 70K claims from 2018–2024. The national median cost per claim is $214.34. Costs vary widely — the 90th percentile is $565.06 per claim, 2.6× the median.

Total Paid

$18.8M

0.00% of all spending

Total Claims

70K

Providers

173

Avg Cost/Claim

$269

National Cost Distribution

How much do providers bill per claim for Q0138? Based on 169 providers billing this code nationally.

Median

$214.34

Average

$291.42

Std Dev

$338.36

Max

$3,594.39

Percentile Distribution (Cost per Claim)

p10
$65.64
p25
$141.70
Median
$214.34
p75
$339.64
p90
$565.06
p95
$698.58
p99
$1,225.29

50% of providers bill between $141.70 and $339.64 per claim for this code.

90% bill between $65.64 and $565.06.

Top 1% bill above $1,225.29.

About This Procedure

HCPCS code Q0138 was billed by 173 providers across 70K claims, totaling $18.8M in Medicaid payments from 2018–2024. This code was used for 45K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$214.34

Providers Billing

169

National Spending

$18.8M

Avg/Median Ratio

1.36×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for Q0138

#ProviderTotal Paid
1Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$2.2M
2Dana-farber Cancer Institute, Inc.

Boston, MA · General Acute Care Hospital

$1.7M
31710930391$995K
4Beth Israel Deaconess Medical Center, Inc.

Boston, MA · General Acute Care Hospital

$852K
5Mount Sinai Hospital

New York, NY · Ambulance

$845K
61295023547$754K
7Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$736K
8The General Hospital Corporation

Boston, MA · General Acute Care Hospital

$684K
9Baystate Medical Center Inc

Springfield, MA · General Acute Care Hospital

$566K
10Saint Mary's Hospital, Inc.

Waterbury, CT · General Acute Care Hospital

$446K
111922175074$446K
121598770471$430K
13Medstar Washington Hospital Center

Washington, DC · General Acute Care Hospital

$373K
14Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$301K
151427069368$290K
161528035995$249K
171932208576$247K
18University Of Rochester

Rochester, NY · General Acute Care Hospital

$245K
19Rector & Visitors Of The University Of Virginia

Charlottesville, VA · General Acute Care Hospital

$235K
201932411493$233K

Showing top 20 of 173 providers billing this code

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