#2429 of 11K

Q5005

HCPCS Procedure Code

HCPCS code Q5005 is the #2,429 most-billed Medicaid procedure code, with $5.8M in payments across 14K claims from 2018–2024. The national median cost per claim is $432.46. Costs vary widely — the 90th percentile is $929.21 per claim, 2.1× the median.

Total Paid

$5.8M

0.00% of all spending

Total Claims

14K

Providers

Avg Cost/Claim

$432

National Cost Distribution

How much do providers bill per claim for Q5005? Based on 11 providers billing this code nationally.

Median

$432.46

Average

$710.11

Std Dev

$1,135.13

Max

$3,967.26

Percentile Distribution (Cost per Claim)

p10

$3.75

p25

$45.77

Median

$432.46

p75

$780.42

p90

$929.21

p95

$2,448.24

p99

$3,663.46

50% of providers bill between $45.77 and $780.42 per claim for this code.

90% bill between $3.75 and $929.21.

Top 1% bill above $3,663.46.

About This Procedure

HCPCS code Q5005 was billed by 25 providers across 14K claims, totaling $5.8M in Medicaid payments from 2018–2024. This code was used for 9K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$432.46

Providers Billing

National Spending

$5.8M

Avg/Median Ratio

1.64×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for Q5005

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1861538209	$2.4M	$799.23	1.8× median	Above 75th
2	1609922707	$1.6M	$432.46	1.0× median	Above Median
3	1033328232	$1.5M	$610.87	1.4× median	Above Median
4	1124028204	$94K	$761.60	1.8× median	Above Median
5	1891724142	$74K	$213.72	0.5× median	Below Median
6	1982651600	$72K	$929.21	2.1× median	Top 10%
7	1568485894	$48K	$3,967.26	9.2× median	Top 1%
8	1922004183	$13K	$28.18	0.1× median	Below Median
9	1861423311	$4K	$3.75	0.0× median	Below Median
10	1174063200	$1K	$63.37	0.1× median	Below Median
11	1629164074	$602	$1.54	0.0× median	Below Median
12	1538369129	$0	$0.00	0.0× median	Below Median
13	1356338529	$0	$0.00	0.0× median	Below Median
14	1801990452	$0	$0.00	0.0× median	Below Median
15	1437139664	$0	$0.00	0.0× median	Below Median
16	1104884642	$0	$0.00	0.0× median	Below Median
17	1639147051	$0	$0.00	0.0× median	Below Median
18	1538197389	$0	$0.00	0.0× median	Below Median
19	1588896989	$0	$0.00	0.0× median	Below Median
20	1164526554	$0	$0.00	0.0× median	Below Median

Showing top 20 of 25 providers billing this code

Related Procedures

Q5003Injection, infliximab-dyyb, biosimilar, 10 mg$589.1M Q5001Injection, filgrastim-sndz, biosimilar, 1 mcg$242.5M Q5004$44.0M Q5009Hospice/home health aide, per 15 min$37.0M Q5006$7.1M

← All procedures Top providers →