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#1731 of 11K

11045

HCPCS Procedure Code

HCPCS code 11045 is the #1,731 most-billed Medicaid procedure code, with $15.2M in payments across 177K claims from 2018–2024. The national median cost per claim is $27.04. Costs vary widely — the 90th percentile is $307.73 per claim, 11.4× the median.

Total Paid

$15.2M

0.00% of all spending

Total Claims

177K

Providers

363

Avg Cost/Claim

$86

National Cost Distribution

How much do providers bill per claim for 11045? Based on 328 providers billing this code nationally.

Median

$27.04

Average

$104.69

Std Dev

$195.50

Max

$2,056.96

Percentile Distribution (Cost per Claim)

p10
$3.96
p25
$10.64
Median
$27.04
p75
$116.03
p90
$307.73
p95
$395.41
p99
$834.17

50% of providers bill between $10.64 and $116.03 per claim for this code.

90% bill between $3.96 and $307.73.

Top 1% bill above $834.17.

About This Procedure

HCPCS code 11045 was billed by 363 providers across 177K claims, totaling $15.2M in Medicaid payments from 2018–2024. This code was used for 76K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$27.04

Providers Billing

328

National Spending

$15.2M

Avg/Median Ratio

3.87×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 11045

#ProviderTotal Paid
1The Queens Medical Center

Honolulu, HI · Psychiatric Unit

$2.4M
2Yuma Regional Medical Center

Yuma, AZ · General Acute Care Hospital

$1.1M
3Newark Beth Israel Medical Center Inc

Newark, NJ · General Acute Care Hospital

$862K
41952309098$824K
5Samaritan Hospital Of Troy, New York

Troy, NY

$727K
6Banner - University Medical Center Phoenix

Phoenix, AZ · Clinic/Center, Sleep Disorder Diagnostic

$553K
7Tucson Medical Center

Tucson, AZ · Clinic/Center, Hearing and Speech

$506K
81740208081$485K
91922139120$465K
101134178999$459K
111144286402$327K
12Summa Health System

Akron, OH · General Acute Care Hospital

$296K
131417947490$252K
141043657141$232K
15Southern Ohio Medical Center

Portsmouth, OH · Clinical Medical Laboratory

$232K
161942796818$231K
171104867167$227K
18Ohiohealth Corporation

Columbus, OH · General Acute Care Hospital

$186K
191700813425$177K
201235212721$158K

Showing top 20 of 363 providers billing this code