Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#4574 of 11K

Q4038

HCPCS Procedure Code

HCPCS code Q4038 is the #4,574 most-billed Medicaid procedure code, with $508K in payments across 17K claims from 2018–2024. The national median cost per claim is $27.24. Costs vary widely — the 90th percentile is $59.80 per claim, 2.2× the median.

Total Paid

$508K

0.00% of all spending

Total Claims

17K

Providers

73

Avg Cost/Claim

$29

National Cost Distribution

How much do providers bill per claim for Q4038? Based on 68 providers billing this code nationally.

Median

$27.24

Average

$32.69

Std Dev

$32.12

Max

$238.23

Percentile Distribution (Cost per Claim)

p10
$7.74
p25
$16.50
Median
$27.24
p75
$38.53
p90
$59.80
p95
$70.79
p99
$142.86

50% of providers bill between $16.50 and $38.53 per claim for this code.

90% bill between $7.74 and $59.80.

Top 1% bill above $142.86.

About This Procedure

HCPCS code Q4038 was billed by 73 providers across 17K claims, totaling $508K in Medicaid payments from 2018–2024. This code was used for 14K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$27.24

Providers Billing

68

National Spending

$508K

Avg/Median Ratio

1.20×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for Q4038

#ProviderTotal Paid
11679771703$82K
21679603724$66K
31265593594$60K
41851347348$49K
51467690602$42K
61215930490$39K
71497253371$18K
81679764229$14K
91508264938$12K
10West Virginia University Hospitals, Inc

Morgantown, WV · Clinical Medical Laboratory

$12K
111255927646$11K
121942300918$8K
131609129626$6K
141902886492$6K
151508838566$6K
161053402040$5K
171619412376$5K
181568644052$5K
191902238694$5K
201437193265$4K

Showing top 20 of 73 providers billing this code