#4593 of 11K

S4005

HCPCS Procedure Code

HCPCS code S4005 is the #4,593 most-billed Medicaid procedure code, with $498K in payments across 9,439 claims from 2018–2024. The national median cost per claim is $106.47.

Total Paid

$498K

0.00% of all spending

Total Claims

9,439

Providers

Avg Cost/Claim

$53

National Cost Distribution

How much do providers bill per claim for S4005? Based on 8 providers billing this code nationally.

Median

$106.47

Average

$99.06

Std Dev

$18.12

Max

$112.22

Percentile Distribution (Cost per Claim)

p10

$80.87

p25

$97.26

Median

$106.47

p75

$109.53

p90

$110.70

p95

$111.46

p99

$112.06

50% of providers bill between $97.26 and $109.53 per claim for this code.

90% bill between $80.87 and $110.70.

Top 1% bill above $112.06.

About This Procedure

HCPCS code S4005 was billed by 23 providers across 9,439 claims, totaling $498K in Medicaid payments from 2018–2024. This code was used for 7,005 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$106.47

Providers Billing

National Spending

$498K

Avg/Median Ratio

0.93×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for S4005

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1598717480	$275K	$90.81	0.9× median	Below Median
2	1134220031	$85K	$110.05	1.0× median	Above 75th
3	1831116441	$57K	$109.35	1.0× median	Above Median
4	1992812580	$50K	$108.53	1.0× median	Above Median
5	1821147786	$11K	$57.67	0.5× median	Below Median
6	1063414233	$9K	$112.22	1.1× median	Top 1%
7	1194713461	$6K	$99.42	0.9× median	Below Median
8	1083644579	$5K	$104.42	1.0× median	Below Median
9	1427248517	$0	$0.00	0.0× median	Below Median
10	1437423647	$0	$0.00	0.0× median	Below Median
11	1093768962	$0	$0.00	0.0× median	Below Median
12	1114365806	$0	$0.00	0.0× median	Below Median
13	1336356211	$0	$0.00	0.0× median	Below Median
14	1518025162	$0	$0.00	0.0× median	Below Median
15	1629206347	$0	$0.00	0.0× median	Below Median
16	1285266395	$0	$0.00	0.0× median	Below Median
17	1255396727	$0	$0.00	0.0× median	Below Median
18	1831570449	$0	$0.00	0.0× median	Below Median
19	Cambridge Public Health Commission Cambridge, MA · General Acute Care Hospital	$0	$0.00	0.0× median	Below Median
20	1902045321	$0	$0.00	0.0× median	Below Median

Showing top 20 of 23 providers billing this code

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