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#3612 of 11K

Q0163

HCPCS Procedure Code

HCPCS code Q0163 is the #3,612 most-billed Medicaid procedure code, with $1.4M in payments across 506K claims from 2018–2024. The national median cost per claim is $0.18. Costs vary widely — the 90th percentile is $3.84 per claim, 21.3× the median.

Total Paid

$1.4M

0.00% of all spending

Total Claims

506K

Providers

385

Avg Cost/Claim

$3

National Cost Distribution

How much do providers bill per claim for Q0163? Based on 271 providers billing this code nationally.

Median

$0.18

Average

$6.16

Std Dev

$37.82

Max

$532.53

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.03
Median
$0.18
p75
$0.86
p90
$3.84
p95
$22.99
p99
$125.82

50% of providers bill between $0.03 and $0.86 per claim for this code.

90% bill between $0.00 and $3.84.

Top 1% bill above $125.82.

About This Procedure

HCPCS code Q0163 was billed by 385 providers across 506K claims, totaling $1.4M in Medicaid payments from 2018–2024. This code was used for 380K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.18

Providers Billing

271

National Spending

$1.4M

Avg/Median Ratio

34.22×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for Q0163

#ProviderTotal Paid
1Variety Children's Hospital

Miami, FL · General Acute Care Hospital Children

$383K
2Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$225K
3Antelope Valley Health Care District

Lancaster, CA · General Acute Care Hospital

$174K
4Yukon-kuskokwim Health Corporation

Bethel, AK · General Acute Care Hospital Rural

$117K
5Lexington Health Inc

West Columbia, SC · General Acute Care Hospital

$48K
6Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$46K
71235196510$43K
81770693939$43K
91447457775$40K
10University Of Kentucky

Lexington, KY · General Acute Care Hospital

$37K
111356366314$26K
12Riverside Hospital Inc

Newport News, VA · Psychiatric Hospital

$20K
131679660617$18K
141881632818$18K
15Virtua - West Jersey Health System Inc.

Voorhees, NJ · General Acute Care Hospital

$16K
161013981554$13K
17Charleston Area Medical Center Inc

Charleston, WV · General Acute Care Hospital

$11K
181699704254$9K
19Lee Memorial Health System

Ft Myers, FL · General Acute Care Hospital

$8K
201194790055$8K

Showing top 20 of 385 providers billing this code