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#427 of 11K

W6110

Waiver service, state-specific code

Waiver service, state-specific code is the #427 most-billed Medicaid procedure code, with $240.9M in payments across 2.3M claims from 2018–2024. The national median cost per claim is $93.98.

Total Paid

$240.9M

0.02% of all spending

Total Claims

2.3M

Providers

3

Avg Cost/Claim

$105

National Cost Distribution

How much do providers bill per claim for W6110? Based on 2 providers billing this code nationally.

Median

$93.98

Average

$93.98

Std Dev

$16.53

Max

$105.67

Percentile Distribution (Cost per Claim)

p10
$84.62
p25
$88.13
Median
$93.98
p75
$99.82
p90
$103.33
p95
$104.50
p99
$105.43

50% of providers bill between $88.13 and $99.82 per claim for this code.

90% bill between $84.62 and $103.33.

Top 1% bill above $105.43.

About This Procedure

HCPCS code W6110 (Waiver service, state-specific code) was billed by 3 providers across 2.3M claims, totaling $240.9M in Medicaid payments from 2018–2024. This code was used for 458K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$93.98

Providers Billing

2

National Spending

$240.9M

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.