#3732 of 11K

S0315

HCPCS Procedure Code

HCPCS code S0315 is the #3,732 most-billed Medicaid procedure code, with $1.3M in payments across 17K claims from 2018–2024. The national median cost per claim is $37.40. Costs vary widely — the 90th percentile is $440.62 per claim, 11.8× the median.

Total Paid

$1.3M

0.00% of all spending

Total Claims

17K

Providers

Avg Cost/Claim

$73

National Cost Distribution

How much do providers bill per claim for S0315? Based on 36 providers billing this code nationally.

Median

$37.40

Average

$138.57

Std Dev

$197.21

Max

$757.96

Percentile Distribution (Cost per Claim)

p10

$7.50

p25

$7.50

Median

$37.40

p75

$172.20

p90

$440.62

p95

$493.64

p99

$667.67

50% of providers bill between $7.50 and $172.20 per claim for this code.

90% bill between $7.50 and $440.62.

Top 1% bill above $667.67.

About This Procedure

HCPCS code S0315 was billed by 38 providers across 17K claims, totaling $1.3M in Medicaid payments from 2018–2024. This code was used for 15K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$37.40

Providers Billing

National Spending

$1.3M

Avg/Median Ratio

3.71×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for S0315

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1144268848	$418K	$757.96	20.3× median	Top 1%
2	1316492218	$337K	$42.23	1.1× median	Above Median
3	1326033788	$113K	$37.71	1.0× median	Above Median
4	Health Managment Of Kansas, Inc. Coffeyville, KS · Home Health	$87K	$85.79	2.3× median	Above Median
5	1427117910	$52K	$156.68	4.2× median	Above Median
6	1760832414	$45K	$415.89	11.1× median	Above 75th
7	1972075869	$39K	$428.86	11.5× median	Above 75th
8	1679889257	$29K	$491.53	13.1× median	Top 10%
9	1891811345	$19K	$452.38	12.1× median	Top 10%
10	1285180307	$16K	$21.05	0.6× median	Below Median
11	1699122341	$16K	$106.84	2.9× median	Above Median
12	1780760710	$13K	$78.30	2.1× median	Above Median
13	1356645998	$12K	$375.00	10.0× median	Above 75th
14	1265751556	$12K	$396.55	10.6× median	Above 75th
15	1154624443	$8K	$13.22	0.4× median	Below Median
16	1033150875	$8K	$29.90	0.8× median	Below Median
17	1952890725	$7K	$120.00	3.2× median	Above Median
18	1346404332	$6K	$500.00	13.4× median	Top 10%
19	1154373843	$5K	$37.10	1.0× median	Below Median
20	D&s Residential Services Lp Nashville, TN · In Home Supportive Care	$5K	$79.37	2.1× median	Above Median

Showing top 20 of 38 providers billing this code

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