Q5004
HCPCS Procedure Code
HCPCS code Q5004 is the #1,068 most-billed Medicaid procedure code, with $44.0M in payments across 349K claims from 2018–2024. The national median cost per claim is $127.12. Costs vary widely — the 90th percentile is $1,654.41 per claim, 13.0× the median.
Total Paid
$44.0M
0.00% of all spending
Total Claims
349K
Providers
147
Avg Cost/Claim
$126
National Cost Distribution
How much do providers bill per claim for Q5004? Based on 52 providers billing this code nationally.
Median
$127.12
Average
$583.84
Std Dev
$1,257.29
Max
$5,384.35
Percentile Distribution (Cost per Claim)
50% of providers bill between $10.35 and $304.39 per claim for this code.
90% bill between $1.00 and $1,654.41.
Top 1% bill above $5,365.31.
About This Procedure
HCPCS code Q5004 was billed by 147 providers across 349K claims, totaling $44.0M in Medicaid payments from 2018–2024. This code was used for 77K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$127.12
Providers Billing
52
National Spending
$44.0M
Avg/Median Ratio
4.59×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for Q5004
| # | Provider | Total Paid |
|---|---|---|
| 1 | Ambercare Hospice Inc. Albuquerque, NM · Hospice Care Community Based | $22.5M |
| 2 | 1598815839 | $8.1M |
| 3 | 1619028313 | $3.1M |
| 4 | 1790782027 | $2.1M |
| 5 | 1225089634 | $1.7M |
| 6 | 1073906590 | $1.5M |
| 7 | 1194894790 | $515K |
| 8 | Odyssey Healthcare Of Marion County Llc Miami, FL · Hospice Care Community Based | $512K |
| 9 | 1952337149 | $507K |
| 10 | 1063926806 | $450K |
| 11 | 1144328881 | $410K |
| 12 | 1790706935 | $279K |
| 13 | 1821427741 | $249K |
| 14 | 1306843651 | $241K |
| 15 | 1730268665 | $224K |
| 16 | 1548825276 | $220K |
| 17 | 1134101983 | $172K |
| 18 | 1982669156 | $145K |
| 19 | 1548268923 | $143K |
| 20 | 1093705949 | $139K |
Showing top 20 of 147 providers billing this code