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#4974 of 11K

Q4196

HCPCS Procedure Code

HCPCS code Q4196 is the #4,974 most-billed Medicaid procedure code, with $333K in payments across 2K claims from 2018–2024. The national median cost per claim is $102.02. Costs vary widely — the 90th percentile is $527.32 per claim, 5.2× the median.

Total Paid

$333K

0.00% of all spending

Total Claims

2K

Providers

8

Avg Cost/Claim

$137

National Cost Distribution

How much do providers bill per claim for Q4196? Based on 4 providers billing this code nationally.

Median

$102.02

Average

$228.33

Std Dev

$323.90

Max

$708.83

Percentile Distribution (Cost per Claim)

p10
$30.38
p25
$75.30
Median
$102.02
p75
$255.05
p90
$527.32
p95
$618.08
p99
$690.68

50% of providers bill between $75.30 and $255.05 per claim for this code.

90% bill between $30.38 and $527.32.

Top 1% bill above $690.68.

About This Procedure

HCPCS code Q4196 was billed by 8 providers across 2K claims, totaling $333K in Medicaid payments from 2018–2024. This code was used for 704 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$102.02

Providers Billing

4

National Spending

$333K

Avg/Median Ratio

2.24×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for Q4196

#ProviderTotal Paid
11437505393$209K
21992071476$74K
31669687513$50K
41578865861$106
5Bridgeport Hospital

Bridgeport, CT · General Acute Care Hospital

$0
61134220031$0
71811258510$0
81891376810$0

Showing top 8 of 8 providers billing this code