Q5103
HCPCS Procedure Code
HCPCS code Q5103 is the #695 most-billed Medicaid procedure code, with $103.2M in payments across 87K claims from 2018–2024. The national median cost per claim is $1,075.28. Costs vary widely — the 90th percentile is $2,514.12 per claim, 2.3× the median.
Total Paid
$103.2M
0.01% of all spending
Total Claims
87K
Providers
123
Avg Cost/Claim
$1K
National Cost Distribution
How much do providers bill per claim for Q5103? Based on 120 providers billing this code nationally.
Median
$1,075.28
Average
$1,415.34
Std Dev
$1,134.50
Max
$6,597.73
Percentile Distribution (Cost per Claim)
50% of providers bill between $744.75 and $1,816.21 per claim for this code.
90% bill between $442.92 and $2,514.12.
Top 1% bill above $6,217.22.
About This Procedure
HCPCS code Q5103 was billed by 123 providers across 87K claims, totaling $103.2M in Medicaid payments from 2018–2024. This code was used for 72K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$1,075.28
Providers Billing
120
National Spending
$103.2M
Avg/Median Ratio
1.32×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for Q5103
| # | Provider | Total Paid |
|---|---|---|
| 1 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $7.3M |
| 2 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $7.1M |
| 3 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $5.9M |
| 4 | University Of Rochester Rochester, NY · General Acute Care Hospital | $4.9M |
| 5 | 1235125717 | $4.9M |
| 6 | Henry Ford Health System Detroit, MI · General Acute Care Hospital | $4.3M |
| 7 | 1184785891 | $3.6M |
| 8 | Children's Hospital Corporation Boston, MA · Clinic/Center | $3.6M |
| 9 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $3.3M |
| 10 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $3.2M |
| 11 | Vhs Childrens Hospital Of Michigan Inc Detroit, MI · Clinic/Center, Ambulatory Surgical | $2.8M |
| 12 | 1831116441 | $2.4M |
| 13 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $2.2M |
| 14 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $2.2M |
| 15 | 1073054714 | $2.1M |
| 16 | 1265462659 | $2.0M |
| 17 | 1689744450 | $1.9M |
| 18 | 1487622296 | $1.7M |
| 19 | Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital | $1.4M |
| 20 | Suny Health Science Center At Syracuse Syracuse, NY · General Acute Care Hospital | $1.4M |
Showing top 20 of 123 providers billing this code