0111
HCPCS Procedure Code
HCPCS code 0111 is the #1,096 most-billed Medicaid procedure code, with $41.2M in payments across 31K claims from 2018–2024. The national median cost per claim is $862.89. Costs vary widely — the 90th percentile is $11,464.03 per claim, 13.3× the median.
Total Paid
$41.2M
0.00% of all spending
Total Claims
31K
Providers
19
Avg Cost/Claim
$1K
National Cost Distribution
How much do providers bill per claim for 0111? Based on 17 providers billing this code nationally.
Median
$862.89
Average
$3,626.62
Std Dev
$5,311.39
Max
$18,258.46
Percentile Distribution (Cost per Claim)
50% of providers bill between $545.46 and $5,309.27 per claim for this code.
90% bill between $145.28 and $11,464.03.
Top 1% bill above $17,263.38.
About This Procedure
HCPCS code 0111 was billed by 19 providers across 31K claims, totaling $41.2M in Medicaid payments from 2018–2024. This code was used for 16K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$862.89
Providers Billing
17
National Spending
$41.2M
Avg/Median Ratio
4.20×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 0111
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1336328244 | $27.2M |
| 2 | 1295181477 | $4.8M |
| 3 | 1336279959 | $3.4M |
| 4 | 1093892275 | $1.6M |
| 5 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $1.5M |
| 6 | 1073665360 | $828K |
| 7 | Kaiser Foundation Health Plan Inc Oakland, CA · Health Maintenance Organization | $536K |
| 8 | 1699986331 | $400K |
| 9 | 1336294040 | $334K |
| 10 | 1487697215 | $250K |
| 11 | 1124173059 | $164K |
| 12 | 1487865184 | $65K |
| 13 | 1922033547 | $41K |
| 14 | 1285845982 | $37K |
| 15 | 1154428688 | $16K |
| 16 | 1831188275 | $9K |
| 17 | 1841492212 | $9K |
| 18 | 1326297078 | $0 |
| 19 | 1780742981 | $0 |
Showing top 19 of 19 providers billing this code