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#1627 of 11K

Z0104

HCPCS Procedure Code

HCPCS code Z0104 is the #1,627 most-billed Medicaid procedure code, with $17.4M in payments across 111K claims from 2018–2024. The national median cost per claim is $141.22.

Total Paid

$17.4M

0.00% of all spending

Total Claims

111K

Providers

40

Avg Cost/Claim

$157

National Cost Distribution

How much do providers bill per claim for Z0104? Based on 40 providers billing this code nationally.

Median

$141.22

Average

$179.74

Std Dev

$181.63

Max

$1,238.86

Percentile Distribution (Cost per Claim)

p10
$132.05
p25
$135.31
Median
$141.22
p75
$143.63
p90
$152.45
p95
$383.22
p99
$920.35

50% of providers bill between $135.31 and $143.63 per claim for this code.

90% bill between $132.05 and $152.45.

Top 1% bill above $920.35.

About This Procedure

HCPCS code Z0104 was billed by 40 providers across 111K claims, totaling $17.4M in Medicaid payments from 2018–2024. This code was used for 36K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$141.22

Providers Billing

40

National Spending

$17.4M

Avg/Median Ratio

1.27×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for Z0104

#ProviderTotal Paid
11316041833$2.7M
21205179132$2.2M
31477503407$1.7M
41760441844$1.5M
51669617197$978K
61356585954$845K
71821101650$688K
81285658708$533K
91083897532$512K
101437555265$497K
111770760043$483K
121043375561$461K
131790851921$446K
141659577369$435K
151952327256$402K
161588729214$382K
171558546374$360K
181801849286$342K
191962495986$326K
201619168952$229K

Showing top 20 of 40 providers billing this code