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#5833 of 11K

S0221

HCPCS Procedure Code

HCPCS code S0221 is the #5,833 most-billed Medicaid procedure code, with $131K in payments across 4K claims from 2018–2024. The national median cost per claim is $86.82. Costs vary widely — the 90th percentile is $281.58 per claim, 3.2× the median.

Total Paid

$131K

0.00% of all spending

Total Claims

4K

Providers

14

Avg Cost/Claim

$33

National Cost Distribution

How much do providers bill per claim for S0221? Based on 10 providers billing this code nationally.

Median

$86.82

Average

$126.46

Std Dev

$99.32

Max

$312.62

Percentile Distribution (Cost per Claim)

p10
$46.95
p25
$56.45
Median
$86.82
p75
$169.19
p90
$281.58
p95
$297.10
p99
$309.51

50% of providers bill between $56.45 and $169.19 per claim for this code.

90% bill between $46.95 and $281.58.

Top 1% bill above $309.51.

About This Procedure

HCPCS code S0221 was billed by 14 providers across 4K claims, totaling $131K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$86.82

Providers Billing

10

National Spending

$131K

Avg/Median Ratio

1.46×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for S0221

#ProviderTotal Paid
11710971429$41K
21033218565$30K
31396774147$24K
41407108335$10K
51689710568$9K
61669474425$8K
71174513444$3K
81306812060$2K
91922058510$2K
101215930573$1K
11Total Longterm Care Inc.

Aurora, CO · PACE Provider Organization

$0
121184691693$0
131689754046$0
141144522855$0

Showing top 14 of 14 providers billing this code