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#2866 of 11K

1159F

HCPCS Procedure Code

HCPCS code 1159F is the #2,866 most-billed Medicaid procedure code, with $3.3M in payments across 37.5M claims from 2018–2024. The national median cost per claim is $0.01. Costs vary widely — the 90th percentile is $0.95 per claim, 95.0× the median.

Total Paid

$3.3M

0.00% of all spending

Total Claims

37.5M

Providers

11K

Avg Cost/Claim

$0

National Cost Distribution

How much do providers bill per claim for 1159F? Based on 2K providers billing this code nationally.

Median

$0.01

Average

$0.83

Std Dev

$6.33

Max

$160.12

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.00
Median
$0.01
p75
$0.13
p90
$0.95
p95
$2.32
p99
$14.98

50% of providers bill between $0.00 and $0.13 per claim for this code.

90% bill between $0.00 and $0.95.

Top 1% bill above $14.98.

About This Procedure

HCPCS code 1159F was billed by 11K providers across 37.5M claims, totaling $3.3M in Medicaid payments from 2018–2024. This code was used for 31.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.01

Providers Billing

2K

National Spending

$3.3M

Avg/Median Ratio

83.00×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 1159F

#ProviderTotal Paid
11013042480$307K
21700886322$297K
31407243223$237K
4Marillac Clinic Inc.

Grand Junction, CO · Clinic/Center Federally Qualified Health Center (FQHC)

$124K
5Niagara Falls Memorial Medical Center

Niagara Falls, NY · General Acute Care Hospital

$113K
61902977705$98K
7St. Barnabas Hospital

Bronx, NY · General Acute Care Hospital

$91K
81770697278$84K
91679672562$51K
101104275882$47K
111417076829$47K
121063969665$43K
131609046267$42K
141518138916$41K
151891775128$37K
161548236623$37K
171386191989$36K
181538441761$36K
191235259607$35K
201235180480$35K

Showing top 20 of 11K providers billing this code