Q4197
HCPCS Procedure Code
HCPCS code Q4197 is the #5,229 most-billed Medicaid procedure code, with $255K in payments across 374 claims from 2018–2024. The national median cost per claim is $238.55. Costs vary widely — the 90th percentile is $1,349.23 per claim, 5.7× the median.
Total Paid
$255K
0.00% of all spending
Total Claims
374
Providers
3
Avg Cost/Claim
$682
National Cost Distribution
How much do providers bill per claim for Q4197? Based on 3 providers billing this code nationally.
Median
$238.55
Average
$628.62
Std Dev
$871.40
Max
$1,626.91
Percentile Distribution (Cost per Claim)
50% of providers bill between $129.47 and $932.73 per claim for this code.
90% bill between $64.02 and $1,349.23.
Top 1% bill above $1,599.14.
About This Procedure
HCPCS code Q4197 was billed by 3 providers across 374 claims, totaling $255K in Medicaid payments from 2018–2024. This code was used for 92 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$238.55
Providers Billing
3
National Spending
$255K
Avg/Median Ratio
2.64×
Highly skewed — outlier-driven
Provider Coverage
We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.