#462 of 11K

S1040

Cranial remolding orthosis, per device

Cranial remolding orthosis, per device is the #462 most-billed Medicaid procedure code, with $206.8M in payments across 111K claims from 2018–2024. The national median cost per claim is $1,936.44.

Total Paid

$206.8M

0.02% of all spending

Total Claims

111K

Providers

148

Avg Cost/Claim

$2K

National Cost Distribution

How much do providers bill per claim for S1040? Based on 148 providers billing this code nationally.

Median

$1,936.44

Average

$2,008.09

Std Dev

$740.29

Max

$4,398.53

Percentile Distribution (Cost per Claim)

p10

$1,176.14

p25

$1,531.21

Median

$1,936.44

p75

$2,444.46

p90

$2,889.92

p95

$3,222.32

p99

$4,233.31

50% of providers bill between $1,531.21 and $2,444.46 per claim for this code.

90% bill between $1,176.14 and $2,889.92.

Top 1% bill above $4,233.31.

About This Procedure

HCPCS code S1040 (Cranial remolding orthosis, per device) was billed by 148 providers across 111K claims, totaling $206.8M in Medicaid payments from 2018–2024. This code was used for 102K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1,936.44

Providers Billing

148

National Spending

$206.8M

Avg/Median Ratio

1.04×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for S1040

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1689661613	$50.4M	$1,828.14	0.9× median	Below Median
2	1568587160	$15.0M	$2,528.73	1.3× median	Above 75th
3	1588842330	$6.8M	$2,892.13	1.5× median	Top 10%
4	1841857596	$6.4M	$1,712.65	0.9× median	Below Median
5	1326048893	$5.6M	$2,383.10	1.2× median	Above Median
6	1336264944	$5.5M	$1,716.64	0.9× median	Below Median
7	1659377836	$5.0M	$3,923.32	2.0× median	Top 10%
8	1063537660	$5.0M	$2,239.71	1.2× median	Above Median
9	1366567950	$5.0M	$1,977.24	1.0× median	Above Median
10	1265557888	$5.0M	$1,354.25	0.7× median	Below Median
11	1508260910	$4.9M	$2,155.66	1.1× median	Above Median
12	1740723907	$4.3M	$1,772.64	0.9× median	Below Median
13	1861918914	$4.0M	$1,349.87	0.7× median	Below Median
14	1235139528	$3.8M	$1,584.96	0.8× median	Below Median
15	1952878167	$3.6M	$1,037.13	0.5× median	Below Median
16	1184607335	$3.6M	$1,542.77	0.8× median	Below Median
17	1427490002	$3.3M	$2,690.16	1.4× median	Above 75th
18	1235541574	$3.1M	$1,407.85	0.7× median	Below Median
19	1134244742	$3.1M	$1,298.89	0.7× median	Below Median
20	1205338860	$2.9M	$1,985.62	1.0× median	Above Median

Showing top 20 of 148 providers billing this code

Related Procedures

S1035$24K

← All procedures Top providers →