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#4256 of 11K

0111A

HCPCS Procedure Code

HCPCS code 0111A is the #4,256 most-billed Medicaid procedure code, with $712K in payments across 20K claims from 2018–2024. The national median cost per claim is $38.84.

Total Paid

$712K

0.00% of all spending

Total Claims

20K

Providers

295

Avg Cost/Claim

$35

National Cost Distribution

How much do providers bill per claim for 0111A? Based on 278 providers billing this code nationally.

Median

$38.84

Average

$40.83

Std Dev

$38.57

Max

$630.37

Percentile Distribution (Cost per Claim)

p10
$21.03
p25
$33.25
Median
$38.84
p75
$41.80
p90
$59.35
p95
$67.00
p99
$80.87

50% of providers bill between $33.25 and $41.80 per claim for this code.

90% bill between $21.03 and $59.35.

Top 1% bill above $80.87.

About This Procedure

HCPCS code 0111A was billed by 295 providers across 20K claims, totaling $712K in Medicaid payments from 2018–2024. This code was used for 18K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$38.84

Providers Billing

278

National Spending

$712K

Avg/Median Ratio

1.05×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0111A

#ProviderTotal Paid
1Dhhs Phs Naihs Shiprock Hospital

Shiprock, NM · General Acute Care Hospital

$62K
2Richard Bone

Chicago, IL · Internal Medicine, Gastroenterology

$51K
31750443503$43K
4Aurora Medical Group, Inc.

Milwaukee, WI · Internal Medicine

$26K
5Children's Hospital Corporation

Boston, MA · Clinic/Center

$20K
6Permanente Medical Group Inc

Stockton, CA · Anesthesiology

$16K
7Permanente Medical Group Inc

Richmond, CA · Internal Medicine

$15K
81619984291$14K
9The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$14K
10Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$14K
11Presbyterian Healthcare Services

Albuquerque, NM · Surgery

$9K
121952386153$9K
13Erie Family Health Center, Inc

Chicago, IL · Clinic/Center, Federally Qualified Health Center (FQHC)

$8K
141144556333$8K
15Brockton Neighborhood Health Center

Brockton, MA · Clinic/Center, Federally Qualified Health Center (FQHC)

$8K
16Texas Children's Hospital

Houston, TX · General Acute Care Hospital Children

$7K
171124013230$7K
18Kaiser Foundation Health Plan Of The Northwest

Portland, OR · General Practice

$7K
191629168232$6K
201093992877$6K

Showing top 20 of 295 providers billing this code