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#7472 of 11K

90611

HCPCS Procedure Code

HCPCS code 90611 is the #7,472 most-billed Medicaid procedure code, with $17K in payments across 13K claims from 2018–2024. The national median cost per claim is $0.01. Costs vary widely — the 90th percentile is $7.82 per claim, 782.0× the median.

Total Paid

$17K

0.00% of all spending

Total Claims

13K

Providers

113

Avg Cost/Claim

$1

National Cost Distribution

How much do providers bill per claim for 90611? Based on 42 providers billing this code nationally.

Median

$0.01

Average

$3.61

Std Dev

$11.59

Max

$68.23

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.00
Median
$0.01
p75
$0.83
p90
$7.82
p95
$16.75
p99
$52.09

50% of providers bill between $0.00 and $0.83 per claim for this code.

90% bill between $0.00 and $7.82.

Top 1% bill above $52.09.

About This Procedure

HCPCS code 90611 was billed by 113 providers across 13K claims, totaling $17K in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.01

Providers Billing

42

National Spending

$17K

Avg/Median Ratio

361.00×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 90611

#ProviderTotal Paid
11295812386$6K
2The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$4K
3Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$2K
4Mount Sinai Hospital

New York, NY · Ambulance

$1K
5The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$1K
6Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$887
7New York City Health And Hospitals Corporation

Bronx, NY · Internal Medicine

$331
8St Lukes Roosevelt Hospital Center

New York, NY · Case Management

$309
9New York City Health And Hospitals Corporation

Brooklyn, NY · Internal Medicine

$252
101568684058$157
11Beth Israel Medical Center

Brooklyn, NY · Psychiatric Unit

$56
121013924372$27
13Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$26
14Cambridge Public Health Commission

Cambridge, MA · General Acute Care Hospital

$24
15Hennepin Healthcare System Inc

Minneapolis, MN · General Acute Care Hospital

$20
16Family Health Centers Of San Diego Inc

San Diego, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$16
171063898096$15
18The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$14
19The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$9
20Community Health Center Inc

Middletown, CT · Counselor, Addiction (Substance Use Disorder)

$3

Showing top 20 of 113 providers billing this code