#5789 of 11K

Q2038

HCPCS Procedure Code

HCPCS code Q2038 is the #5,789 most-billed Medicaid procedure code, with $137K in payments across 49K claims from 2018–2024. The national median cost per claim is $3.31. Costs vary widely — the 90th percentile is $18.54 per claim, 5.6× the median.

Total Paid

$137K

0.00% of all spending

Total Claims

49K

Providers

357

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for Q2038? Based on 160 providers billing this code nationally.

Median

$3.31

Average

$7.95

Std Dev

$15.68

Max

$128.05

Percentile Distribution (Cost per Claim)

p10

$0.33

p25

$0.71

Median

$3.31

p75

$8.74

p90

$18.54

p95

$27.00

p99

$77.89

50% of providers bill between $0.71 and $8.74 per claim for this code.

90% bill between $0.33 and $18.54.

Top 1% bill above $77.89.

About This Procedure

HCPCS code Q2038 was billed by 357 providers across 49K claims, totaling $137K in Medicaid payments from 2018–2024. This code was used for 46K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3.31

Providers Billing

160

National Spending

$137K

Avg/Median Ratio

2.40×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for Q2038

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1376521575	$45K	$13.58	4.1× median	Above 75th
2	1023041159	$13K	$18.52	5.6× median	Above 75th
3	1730115213	$6K	$7.52	2.3× median	Above Median
4	1629066238	$5K	$0.61	0.2× median	Below Median
5	1568735660	$4K	$20.53	6.2× median	Top 10%
6	1053343509	$3K	$16.09	4.9× median	Above 75th
7	1619915006	$3K	$18.71	5.7× median	Top 10%
8	Summa Health System Akron, OH · General Acute Care Hospital	$3K	$3.11	0.9× median	Below Median
9	1003814641	$3K	$28.37	8.6× median	Top 10%
10	St Lukes Roosevelt Hospital Center New York, NY · Case Management	$2K	$25.44	7.7× median	Top 10%
11	1427437326	$2K	$0.55	0.2× median	Below Median
12	1700429610	$2K	$128.05	38.7× median	Top 1%
13	1891780516	$2K	$21.61	6.5× median	Top 10%
14	1710499462	$2K	$12.57	3.8× median	Above 75th
15	1780654962	$1K	$123.42	37.3× median	Top 1%
16	1760430532	$1K	$2.39	0.7× median	Below Median
17	1053373480	$1K	$7.88	2.4× median	Above Median
18	Maricopa County Special Health Care District Phoenix, AZ · General Acute Care Hospital	$1K	$0.34	0.1× median	Below Median
19	1417378597	$1K	$4.18	1.3× median	Above Median
20	1548610314	$1K	$41.61	12.6× median	Top 10%

Showing top 20 of 357 providers billing this code

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