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#5911 of 11K

S0080

HCPCS Procedure Code

HCPCS code S0080 is the #5,911 most-billed Medicaid procedure code, with $120K in payments across 4,093 claims from 2018–2024. The national median cost per claim is $12.22. Costs vary widely — the 90th percentile is $84.45 per claim, 6.9× the median.

Total Paid

$120K

0.00% of all spending

Total Claims

4,093

Providers

12

Avg Cost/Claim

$29

National Cost Distribution

How much do providers bill per claim for S0080? Based on 10 providers billing this code nationally.

Median

$12.22

Average

$30.52

Std Dev

$36.18

Max

$84.96

Percentile Distribution (Cost per Claim)

p10
$1.54
p25
$3.50
Median
$12.22
p75
$62.92
p90
$84.45
p95
$84.70
p99
$84.91

50% of providers bill between $3.50 and $62.92 per claim for this code.

90% bill between $1.54 and $84.45.

Top 1% bill above $84.91.

About This Procedure

HCPCS code S0080 was billed by 12 providers across 4,093 claims, totaling $120K in Medicaid payments from 2018–2024. This code was used for 3,590 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.22

Providers Billing

10

National Spending

$120K

Avg/Median Ratio

2.50×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for S0080

#ProviderTotal Paid
1Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$111K
2Vhs Childrens Hospital Of Michigan Inc

Detroit, MI · Clinic/Center, Ambulatory Surgical

$3K
3Memorial Hospital For Cancer And Allied Diseases

New York, NY · Pharmacy

$2K
4Upmc Children's Hospital Of Pittsburgh

Pittsburgh, PA · Clinic/Center

$1K
5Childrens Hospital Of Philadelphia

Philadelphia, PA · General Acute Care Hospital Children

$1K
6Inova Health Care Services

Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder

$708
7Childrens Hospital Of The Kings Daughters Inc

Norfolk, VA · Social Worker, Clinical

$317
81699119818$244
9Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$244
101033112230$52
111144471715$0
12Connecticut Children's Medical Center

Hartford, CT · General Acute Care Hospital, Children

$0

Showing top 12 of 12 providers billing this code

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