Q5111
HCPCS Procedure Code
HCPCS code Q5111 is the #1,365 most-billed Medicaid procedure code, with $25.6M in payments across 15K claims from 2018–2024. The national median cost per claim is $1,602.88.
Total Paid
$25.6M
0.00% of all spending
Total Claims
15K
Providers
61
Avg Cost/Claim
$2K
National Cost Distribution
How much do providers bill per claim for Q5111? Based on 61 providers billing this code nationally.
Median
$1,602.88
Average
$1,743.16
Std Dev
$941.99
Max
$3,757.59
Percentile Distribution (Cost per Claim)
50% of providers bill between $1,237.29 and $2,290.44 per claim for this code.
90% bill between $444.25 and $3,112.23.
Top 1% bill above $3,653.35.
About This Procedure
HCPCS code Q5111 was billed by 61 providers across 15K claims, totaling $25.6M in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$1,602.88
Providers Billing
61
National Spending
$25.6M
Avg/Median Ratio
1.09×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for Q5111
| # | Provider | Total Paid |
|---|---|---|
| 1 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $3.1M |
| 2 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $2.3M |
| 3 | Maimonides Medical Center Brooklyn, NY · General Acute Care Hospital | $2.3M |
| 4 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $2.0M |
| 5 | Banner - University Medical Center Tucson Campus Llc Tucson, AZ · Clinic/Center, Multi-Specialty | $1.8M |
| 6 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $1.7M |
| 7 | Swedish Health Services Seattle, WA · General Acute Care Hospital | $1.1M |
| 8 | Englewood Hospital And Medical Center Englewood, NJ · General Acute Care Hospital | $941K |
| 9 | 1316900277 | $608K |
| 10 | 1699884858 | $591K |
| 11 | Riverside University Health Systems - Medical Center Moreno Valley, CA · General Acute Care Hospital | $529K |
| 12 | Inova Health Care Services Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder | $515K |
| 13 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $513K |
| 14 | 1104859131 | $475K |
| 15 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $436K |
| 16 | 1801850243 | $424K |
| 17 | City & County Of San Francisco San Francisco, CA · Case Manager/Care Coordinator | $406K |
| 18 | 1437230034 | $400K |
| 19 | Mount Sinai Hospital New York, NY · Ambulance | $390K |
| 20 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $379K |
Showing top 20 of 61 providers billing this code