S0281
HCPCS Procedure Code
HCPCS code S0281 is the #559 most-billed Medicaid procedure code, with $148.0M in payments across 1.9M claims from 2018–2024. The national median cost per claim is $92.97. Costs vary widely — the 90th percentile is $245.01 per claim, 2.6× the median.
Total Paid
$148.0M
0.01% of all spending
Total Claims
1.9M
Providers
406
Avg Cost/Claim
$78
National Cost Distribution
How much do providers bill per claim for S0281? Based on 339 providers billing this code nationally.
Median
$92.97
Average
$109.55
Std Dev
$116.63
Max
$690.45
Percentile Distribution (Cost per Claim)
50% of providers bill between $14.49 and $138.46 per claim for this code.
90% bill between $4.16 and $245.01.
Top 1% bill above $545.16.
About This Procedure
HCPCS code S0281 was billed by 406 providers across 1.9M claims, totaling $148.0M in Medicaid payments from 2018–2024. This code was used for 1.8M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$92.97
Providers Billing
339
National Spending
$148.0M
Avg/Median Ratio
1.18×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for S0281
| # | Provider | Total Paid |
|---|---|---|
| 1 | South Dakota Achieve Sioux Falls, SD · Clinic/Center Developmental Disabilities | $10.7M |
| 2 | Black Hills Works Inc Rapid City, SD · Day Training Developmentally Disabled Services | $9.7M |
| 3 | 1215947809 | $7.1M |
| 4 | 1134367063 | $4.8M |
| 5 | 1225067317 | $4.6M |
| 6 | Huron Area Center For Independence Huron, SD · Clinic/Center Developmental Disabilities | $4.6M |
| 7 | 1558761981 | $4.6M |
| 8 | Dakotabilities Sioux Falls, SD · Voluntary or Charitable | $4.4M |
| 9 | Volunteers Of America Dakotas Sioux Falls, SD · Residential Treatment Facility Intellectual and/or Developmental Disabilities | $3.7M |
| 10 | 1932254760 | $3.3M |
| 11 | Nystrom & Associates, Ltd New Brighton, MN · Marriage & Family Therapist | $3.1M |
| 12 | 1366526782 | $3.0M |
| 13 | 1578600417 | $3.0M |
| 14 | 1659419653 | $2.8M |
| 15 | 1114002573 | $2.7M |
| 16 | 1861514945 | $2.7M |
| 17 | 1124174651 | $2.7M |
| 18 | Nv St Dv Mh Ds Desert Dev Center Las Vegas, NV · Respite Care Respite Care Intellectual and/or Developmental Disabilities Child | $2.5M |
| 19 | 1124158811 | $2.5M |
| 20 | 1952370561 | $2.4M |
Showing top 20 of 406 providers billing this code