#2665 of 11K

11057

HCPCS Procedure Code

HCPCS code 11057 is the #2,665 most-billed Medicaid procedure code, with $4.3M in payments across 305K claims from 2018–2024. The national median cost per claim is $15.10. Costs vary widely — the 90th percentile is $41.28 per claim, 2.7× the median.

Total Paid

$4.3M

0.00% of all spending

Total Claims

305K

Providers

514

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for 11057? Based on 469 providers billing this code nationally.

Median

$15.10

Average

$19.37

Std Dev

$19.88

Max

$182.33

Percentile Distribution (Cost per Claim)

p10

$1.94

p25

$6.44

Median

$15.10

p75

$25.23

p90

$41.28

p95

$51.15

p99

$101.16

50% of providers bill between $6.44 and $25.23 per claim for this code.

90% bill between $1.94 and $41.28.

Top 1% bill above $101.16.

About This Procedure

HCPCS code 11057 was billed by 514 providers across 305K claims, totaling $4.3M in Medicaid payments from 2018–2024. This code was used for 259K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$15.10

Providers Billing

469

National Spending

$4.3M

Avg/Median Ratio

1.28×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 11057

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1326018250	$212K	$51.02	3.4× median	Top 10%
2	1548685258	$133K	$11.99	0.8× median	Below Median
3	1013013002	$123K	$20.03	1.3× median	Above Median
4	1245780303	$122K	$3.75	0.2× median	Below Median
5	The Metrohealth System Cleveland, OH · General Acute Care Hospital	$97K	$147.73	9.8× median	Top 1%
6	1720037138	$74K	$9.26	0.6× median	Below Median
7	1851622153	$74K	$36.31	2.4× median	Above 75th
8	1538118963	$72K	$13.13	0.9× median	Below Median
9	1154450393	$72K	$7.79	0.5× median	Below Median
10	1235202136	$71K	$19.17	1.3× median	Above Median
11	1114280427	$68K	$17.32	1.1× median	Above Median
12	1942484472	$66K	$22.22	1.5× median	Above Median
13	1063554475	$62K	$13.68	0.9× median	Below Median
14	1346435765	$61K	$7.49	0.5× median	Below Median
15	1639352024	$57K	$25.85	1.7× median	Above 75th
16	1811092687	$57K	$14.17	0.9× median	Below Median
17	1073880936	$55K	$27.77	1.8× median	Above 75th
18	1598833683	$52K	$16.73	1.1× median	Above Median
19	1861502403	$51K	$46.49	3.1× median	Top 10%
20	1124358858	$47K	$19.80	1.3× median	Above Median

Showing top 20 of 514 providers billing this code

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