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#5251 of 11K

Q4040

HCPCS Procedure Code

HCPCS code Q4040 is the #5,251 most-billed Medicaid procedure code, with $250K in payments across 7,788 claims from 2018–2024. The national median cost per claim is $16.38. Costs vary widely — the 90th percentile is $57.84 per claim, 3.5× the median.

Total Paid

$250K

0.00% of all spending

Total Claims

7,788

Providers

12

Avg Cost/Claim

$32

National Cost Distribution

How much do providers bill per claim for Q4040? Based on 11 providers billing this code nationally.

Median

$16.38

Average

$26.76

Std Dev

$22.08

Max

$65.17

Percentile Distribution (Cost per Claim)

p10
$7.32
p25
$11.09
Median
$16.38
p75
$43.18
p90
$57.84
p95
$61.50
p99
$64.44

50% of providers bill between $11.09 and $43.18 per claim for this code.

90% bill between $7.32 and $57.84.

Top 1% bill above $64.44.

About This Procedure

HCPCS code Q4040 was billed by 12 providers across 7,788 claims, totaling $250K in Medicaid payments from 2018–2024. This code was used for 4,944 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$16.38

Providers Billing

11

National Spending

$250K

Avg/Median Ratio

1.63×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for Q4040

#ProviderTotal Paid
1Children's Specialized Hospital

New Brunswick, NJ · Pediatrics

$171K
21801869250$30K
31467690602$15K
4Ou Health Partners, Inc

Oklahoma City, OK · Clinic/Center, Multi-Specialty

$12K
51508264938$9K
61942300918$5K
7Dayton Children's Hospital

Dayton, OH · General Acute Care Hospital, Children

$2K
81679771703$2K
91053402040$2K
101386786838$901
11Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$736
12Ut Physicians

Houston, TX · Emergency Medicine

$0

Showing top 12 of 12 providers billing this code