W0104
HCPCS Procedure Code
HCPCS code W0104 is the #5,364 most-billed Medicaid procedure code, with $218K in payments across 4,322 claims from 2018–2024. The national median cost per claim is $59.42. Costs vary widely — the 90th percentile is $154.49 per claim, 2.6× the median.
Total Paid
$218K
0.00% of all spending
Total Claims
4,322
Providers
4
Avg Cost/Claim
$51
National Cost Distribution
How much do providers bill per claim for W0104? Based on 4 providers billing this code nationally.
Median
$59.42
Average
$82.53
Std Dev
$75.74
Max
$192.16
Percentile Distribution (Cost per Claim)
50% of providers bill between $43.97 and $97.97 per claim for this code.
90% bill between $29.06 and $154.49.
Top 1% bill above $188.39.
About This Procedure
HCPCS code W0104 was billed by 4 providers across 4,322 claims, totaling $218K in Medicaid payments from 2018–2024. This code was used for 336 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$59.42
Providers Billing
4
National Spending
$218K
Avg/Median Ratio
1.39×
Normal distribution
Provider Coverage
We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.