#1846 of 11K

Q5105

HCPCS Procedure Code

HCPCS code Q5105 is the #1,846 most-billed Medicaid procedure code, with $12.8M in payments across 598K claims from 2018–2024. The national median cost per claim is $17.05. Costs vary widely — the 90th percentile is $88.73 per claim, 5.2× the median.

Total Paid

$12.8M

0.00% of all spending

Total Claims

598K

Providers

172

Avg Cost/Claim

$21

National Cost Distribution

How much do providers bill per claim for Q5105? Based on 142 providers billing this code nationally.

Median

$17.05

Average

$31.97

Std Dev

$45.68

Max

$263.86

Percentile Distribution (Cost per Claim)

p10

$0.76

p25

$3.67

Median

$17.05

p75

$37.77

p90

$88.73

p95

$118.16

p99

$222.71

50% of providers bill between $3.67 and $37.77 per claim for this code.

90% bill between $0.76 and $88.73.

Top 1% bill above $222.71.

About This Procedure

HCPCS code Q5105 was billed by 172 providers across 598K claims, totaling $12.8M in Medicaid payments from 2018–2024. This code was used for 63K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$17.05

Providers Billing

142

National Spending

$12.8M

Avg/Median Ratio

1.88×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for Q5105

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1700049145	$1.4M	$35.79	2.1× median	Above Median
2	Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital	$1.4M	$20.90	1.2× median	Above Median
3	1063454619	$739K	$56.31	3.3× median	Above 75th
4	1124118948	$654K	$67.25	3.9× median	Above 75th
5	1437197985	$590K	$47.40	2.8× median	Above 75th
6	1891897211	$479K	$106.41	6.2× median	Top 10%
7	St Petersburg Kidney Care South Llc St Petersburg, FL · Clinic/Center End-Stage Renal Disease (ESRD) Treatment	$463K	$90.37	5.3× median	Top 10%
8	Arrowhead Regional Medical Center Colton, CA · General Acute Care Hospital	$376K	$30.80	1.8× median	Above Median
9	1568411940	$364K	$20.59	1.2× median	Above Median
10	1225033020	$327K	$146.68	8.6× median	Top 10%
11	1669472882	$325K	$14.78	0.9× median	Below Median
12	Laurel Canyon Dialysis Llc Sun Valley, CA · Clinic/Center End-Stage Renal Disease (ESRD) Treatment	$284K	$44.12	2.6× median	Above 75th
13	1538199658	$251K	$41.49	2.4× median	Above 75th
14	1578675476	$208K	$27.55	1.6× median	Above Median
15	1578947636	$193K	$102.55	6.0× median	Top 10%
16	1205835246	$188K	$30.21	1.8× median	Above Median
17	1306958111	$188K	$42.66	2.5× median	Above 75th
18	1922110733	$172K	$25.56	1.5× median	Above Median
19	1003233180	$172K	$10.40	0.6× median	Below Median
20	1568574374	$171K	$64.76	3.8× median	Above 75th

Showing top 20 of 172 providers billing this code

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Q5103$103.2M Q5104$59.6M Q5107$34.2M Q5111$25.6M Q5108$19.3M

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