#3546 of 11K

Q5101

HCPCS Procedure Code

HCPCS code Q5101 is the #3,546 most-billed Medicaid procedure code, with $1.5M in payments across 18K claims from 2018–2024. The national median cost per claim is $90.82.

Total Paid

$1.5M

0.00% of all spending

Total Claims

18K

Providers

Avg Cost/Claim

$86

National Cost Distribution

How much do providers bill per claim for Q5101? Based on 21 providers billing this code nationally.

Median

$90.82

Average

$90.59

Std Dev

$67.46

Max

$213.69

Percentile Distribution (Cost per Claim)

p10

$7.29

p25

$20.35

Median

$90.82

p75

$135.94

p90

$179.57

p95

$196.86

p99

$210.32

50% of providers bill between $20.35 and $135.94 per claim for this code.

90% bill between $7.29 and $179.57.

Top 1% bill above $210.32.

About This Procedure

HCPCS code Q5101 was billed by 21 providers across 18K claims, totaling $1.5M in Medicaid payments from 2018–2024. This code was used for 5,089 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$90.82

Providers Billing

National Spending

$1.5M

Avg/Median Ratio

1.00×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for Q5101

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1457409674	$807K	$117.08	1.3× median	Above Median
2	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$264K	$90.82	1.0× median	Below Median
3	1679660617	$187K	$69.20	0.8× median	Below Median
4	Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy	$126K	$125.31	1.4× median	Above Median
5	1528042884	$25K	$41.00	0.5× median	Below Median
6	1770690695	$18K	$196.86	2.2× median	Top 10%
7	Swedish Health Services Seattle, WA · General Acute Care Hospital	$15K	$150.50	1.7× median	Above 75th
8	Aurora Health Care Metro, Inc. Milwaukee, WI · Internal Medicine, Hematology & Oncology	$14K	$20.35	0.2× median	Below Median
9	1598770471	$13K	$213.69	2.4× median	Top 1%
10	Maimonides Medical Center Brooklyn, NY · General Acute Care Hospital	$9K	$170.75	1.9× median	Above 75th
11	University Of California Irvine Orange, CA · General Acute Care Hospital	$8K	$16.45	0.2× median	Below Median
12	1780653618	$7K	$82.09	0.9× median	Below Median
13	City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital	$7K	$68.08	0.7× median	Below Median
14	Mount Sinai Hospital New York, NY · Ambulance	$6K	$91.67	1.0× median	Above Median
15	1518941186	$6K	$179.57	2.0× median	Top 10%
16	Banner - University Medical Center Tucson Campus Llc Tucson, AZ · Clinic/Center, Multi-Specialty	$5K	$107.27	1.2× median	Above Median
17	1164493847	$5K	$135.94	1.5× median	Above 75th
18	1780757856	$3K	$15.17	0.2× median	Below Median
19	1083661607	$2K	$3.27	0.0× median	Below Median
20	1316027709	$321	$7.29	0.1× median	Below Median

Showing top 20 of 21 providers billing this code

Related Procedures

Q5103$103.2M Q5104$59.6M Q5107$34.2M Q5111$25.6M Q5108$19.3M

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