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#1155 of 11K

00811

HCPCS Procedure Code

HCPCS code 00811 is the #1,155 most-billed Medicaid procedure code, with $36.5M in payments across 579K claims from 2018–2024. The national median cost per claim is $56.15. Costs vary widely — the 90th percentile is $120.76 per claim, 2.2× the median.

Total Paid

$36.5M

0.00% of all spending

Total Claims

579K

Providers

1K

Avg Cost/Claim

$63

National Cost Distribution

How much do providers bill per claim for 00811? Based on 1K providers billing this code nationally.

Median

$56.15

Average

$70.86

Std Dev

$105.71

Max

$2,393.33

Percentile Distribution (Cost per Claim)

p10
$16.18
p25
$32.58
Median
$56.15
p75
$86.25
p90
$120.76
p95
$154.54
p99
$292.78

50% of providers bill between $32.58 and $86.25 per claim for this code.

90% bill between $16.18 and $120.76.

Top 1% bill above $292.78.

About This Procedure

HCPCS code 00811 was billed by 1K providers across 579K claims, totaling $36.5M in Medicaid payments from 2018–2024. This code was used for 503K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$56.15

Providers Billing

1K

National Spending

$36.5M

Avg/Median Ratio

1.26×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 00811

#ProviderTotal Paid
11962701458$2.7M
21609804541$1.5M
31508947441$1.5M
41396131272$1.1M
51316185390$651K
61386971687$500K
71588938682$414K
81952497117$404K
91972126209$384K
101437537495$369K
111891235404$369K
121417994872$363K
131871986372$363K
141699710749$363K
151033115415$359K
161336258128$349K
171982906079$349K
181952392946$342K
19Yuma Regional Medical Center

Yuma, AZ · General Acute Care Hospital

$315K
201912335803$315K

Showing top 20 of 1K providers billing this code