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#4539 of 11K

W1011

HCPCS Procedure Code

HCPCS code W1011 is the #4,539 most-billed Medicaid procedure code, with $526K in payments across 6K claims from 2018–2024. The national median cost per claim is $53.96. Costs vary widely — the 90th percentile is $152.93 per claim, 2.8× the median.

Total Paid

$526K

0.00% of all spending

Total Claims

6K

Providers

14

Avg Cost/Claim

$83

National Cost Distribution

How much do providers bill per claim for W1011? Based on 14 providers billing this code nationally.

Median

$53.96

Average

$80.17

Std Dev

$55.42

Max

$184.44

Percentile Distribution (Cost per Claim)

p10
$25.16
p25
$38.59
Median
$53.96
p75
$127.98
p90
$152.93
p95
$166.44
p99
$180.84

50% of providers bill between $38.59 and $127.98 per claim for this code.

90% bill between $25.16 and $152.93.

Top 1% bill above $180.84.

About This Procedure

HCPCS code W1011 was billed by 14 providers across 6K claims, totaling $526K in Medicaid payments from 2018–2024. This code was used for 4K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$53.96

Providers Billing

14

National Spending

$526K

Avg/Median Ratio

1.49×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for W1011

#ProviderTotal Paid
11912121633$365K
21003937566$51K
31730220260$40K
41033635479$23K
5Service Access And Management Inc

Reading, PA · Community/Behavioral Health

$14K
61386199768$8K
71760919369$6K
81538425053$5K
91326384090$4K
101659828887$3K
111699234112$2K
121871911776$2K
131609110543$2K
141013432012$1K

Showing top 14 of 14 providers billing this code

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