Q5116
HCPCS Procedure Code
HCPCS code Q5116 is the #2,719 most-billed Medicaid procedure code, with $4.0M in payments across 6,106 claims from 2018–2024. The national median cost per claim is $1,149.66.
Total Paid
$4.0M
0.00% of all spending
Total Claims
6,106
Providers
12
Avg Cost/Claim
$655
National Cost Distribution
How much do providers bill per claim for Q5116? Based on 11 providers billing this code nationally.
Median
$1,149.66
Average
$1,717.13
Std Dev
$2,716.89
Max
$9,617.51
Percentile Distribution (Cost per Claim)
50% of providers bill between $288.16 and $1,651.55 per claim for this code.
90% bill between $37.45 and $2,058.97.
Top 1% bill above $8,861.66.
About This Procedure
HCPCS code Q5116 was billed by 12 providers across 6,106 claims, totaling $4.0M in Medicaid payments from 2018–2024. This code was used for 3,845 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$1,149.66
Providers Billing
11
National Spending
$4.0M
Avg/Median Ratio
1.49×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for Q5116
| # | Provider | Total Paid |
|---|---|---|
| 1 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $1.2M |
| 2 | 1538157508 | $789K |
| 3 | Upmc Magee-womens Hospital Pittsburgh, PA · General Acute Care Hospital | $531K |
| 4 | Robert Wood Johnson University Hospital, Inc New Brunswick, NJ · General Acute Care Hospital | $504K |
| 5 | 1780653618 | $492K |
| 6 | 1295023547 | $360K |
| 7 | Riverside Hospital Inc Newport News, VA · Psychiatric Hospital | $72K |
| 8 | Henry Ford Health St. John Hospital Chicago, IL · Clinic/Center, Ambulatory Surgical | $51K |
| 9 | 1285845982 | $15K |
| 10 | 1699986331 | $13K |
| 11 | 1083661607 | $5K |
| 12 | 1487865184 | $0 |
Showing top 12 of 12 providers billing this code