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#1453 of 11K

Q5117

HCPCS Procedure Code

HCPCS code Q5117 is the #1,453 most-billed Medicaid procedure code, with $22.8M in payments across 17K claims from 2018–2024. The national median cost per claim is $1,034.41. Costs vary widely — the 90th percentile is $2,789.58 per claim, 2.7× the median.

Total Paid

$22.8M

0.00% of all spending

Total Claims

17K

Providers

33

Avg Cost/Claim

$1K

National Cost Distribution

How much do providers bill per claim for Q5117? Based on 32 providers billing this code nationally.

Median

$1,034.41

Average

$1,451.93

Std Dev

$1,049.20

Max

$4,389.74

Percentile Distribution (Cost per Claim)

p10
$367.78
p25
$792.68
Median
$1,034.41
p75
$2,287.79
p90
$2,789.58
p95
$2,998.13
p99
$3,982.95

50% of providers bill between $792.68 and $2,287.79 per claim for this code.

90% bill between $367.78 and $2,789.58.

Top 1% bill above $3,982.95.

About This Procedure

HCPCS code Q5117 was billed by 33 providers across 17K claims, totaling $22.8M in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1,034.41

Providers Billing

32

National Spending

$22.8M

Avg/Median Ratio

1.40×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for Q5117

#ProviderTotal Paid
1Alivia Specialty Llc

Guaynabo, PR · Pharmacy Specialty Pharmacy

$3.6M
2Memorial Hospital For Cancer And Allied Diseases

New York, NY · Pharmacy

$2.9M
3City Of Hope National Medical Center

Duarte, CA · General Acute Care Hospital

$2.7M
41528018389$1.9M
5Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$1.8M
6The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$1.6M
7Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$1.1M
8Hmh Hospitals Corporation

Hackensack, NJ · Ambulance

$895K
9Women & Infants Hospital Of Rhode Island

Providence, RI · Clinic/Center, Ambulatory Family Planning Facility

$777K
10University Of California Irvine

Orange, CA · General Acute Care Hospital

$770K
11Cooperman Barnabas Medical Center Inc

Livingston, NJ · General Acute Care Hospital

$716K
12County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$703K
13Robert Wood Johnson University Hospital, Inc

New Brunswick, NJ · General Acute Care Hospital

$495K
14The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$437K
151871886366$355K
161164493847$333K
17Aurora Health Care Metro, Inc.

Milwaukee, WI · Internal Medicine, Hematology & Oncology

$259K
181316900277$198K
191770690695$192K
20Dana-farber Cancer Institute, Inc.

Boston, MA · General Acute Care Hospital

$188K

Showing top 20 of 33 providers billing this code