Q5104
HCPCS Procedure Code
HCPCS code Q5104 is the #913 most-billed Medicaid procedure code, with $59.6M in payments across 35K claims from 2018–2024. The national median cost per claim is $1,412.69. Costs vary widely — the 90th percentile is $3,270.59 per claim, 2.3× the median.
Total Paid
$59.6M
0.01% of all spending
Total Claims
35K
Providers
77
Avg Cost/Claim
$2K
National Cost Distribution
How much do providers bill per claim for Q5104? Based on 72 providers billing this code nationally.
Median
$1,412.69
Average
$1,690.56
Std Dev
$1,097.06
Max
$5,013.24
Percentile Distribution (Cost per Claim)
50% of providers bill between $991.80 and $2,144.40 per claim for this code.
90% bill between $674.33 and $3,270.59.
Top 1% bill above $4,959.24.
About This Procedure
HCPCS code Q5104 was billed by 77 providers across 35K claims, totaling $59.6M in Medicaid payments from 2018–2024. This code was used for 25K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$1,412.69
Providers Billing
72
National Spending
$59.6M
Avg/Median Ratio
1.20×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for Q5104
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1710057500 | $12.1M |
| 2 | Nyu Langone Hospitals New York, NY · Clinic/Center, Oncology | $6.0M |
| 3 | 1245248939 | $4.3M |
| 4 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $4.1M |
| 5 | Arthritis & Rheumatology Associates Of South Jersey Pc Vineland, NJ · Internal Medicine Rheumatology | $3.9M |
| 6 | Spectrum Health Hospitals Grand Rapids, MI · General Acute Care Hospital | $3.6M |
| 7 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $2.8M |
| 8 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $2.6M |
| 9 | University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital | $2.4M |
| 10 | 1164746756 | $2.1M |
| 11 | Eastern Maine Medical Center Bangor, ME · General Acute Care Hospital | $1.7M |
| 12 | State Of Connecticut Farmington, CT · Counselor, Professional | $1.1M |
| 13 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $1.0M |
| 14 | 1447308168 | $931K |
| 15 | 1437119310 | $866K |
| 16 | Ohio State University Hospitals Columbus, OH · General Acute Care Hospital | $837K |
| 17 | Mount Sinai Hospital New York, NY · Ambulance | $755K |
| 18 | 1487622296 | $749K |
| 19 | 1235125717 | $728K |
| 20 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $562K |
Showing top 20 of 77 providers billing this code