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#6011 of 11K

S0516

HCPCS Procedure Code

HCPCS code S0516 is the #6,011 most-billed Medicaid procedure code, with $106K in payments across 4,892 claims from 2018–2024. The national median cost per claim is $15.98.

Total Paid

$106K

0.00% of all spending

Total Claims

4,892

Providers

56

Avg Cost/Claim

$22

National Cost Distribution

How much do providers bill per claim for S0516? Based on 52 providers billing this code nationally.

Median

$15.98

Average

$18.47

Std Dev

$20.96

Max

$166.18

Percentile Distribution (Cost per Claim)

p10
$15.75
p25
$15.98
Median
$15.98
p75
$15.98
p90
$15.98
p95
$16.42
p99
$90.10

50% of providers bill between $15.98 and $15.98 per claim for this code.

90% bill between $15.75 and $15.98.

Top 1% bill above $90.10.

About This Procedure

HCPCS code S0516 was billed by 56 providers across 4,892 claims, totaling $106K in Medicaid payments from 2018–2024. This code was used for 4,788 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$15.98

Providers Billing

52

National Spending

$106K

Avg/Median Ratio

1.16×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for S0516

#ProviderTotal Paid
11942644661$47K
2Premier Eye Care Of Florida Llc

Coral Gables, FL · Exclusive Provider Organization

$12K
31467894782$5K
41326031527$4K
51063838274$3K
61912049511$3K
71629029400$3K
81265438956$3K
91912046590$2K
101821098401$1K
111053609420$1K
121578979647$1K
131902903511$1K
141891762514$991
151174623292$991
161891796314$895
171265597066$847
181407857766$799
191114604501$767
201225189806$767

Showing top 20 of 56 providers billing this code