S4991
HCPCS Procedure Code
HCPCS code S4991 is the #7,533 most-billed Medicaid procedure code, with $15K in payments across 4K claims from 2018–2024. The national median cost per claim is $0.05. Costs vary widely — the 90th percentile is $33.56 per claim, 671.2× the median.
Total Paid
$15K
0.00% of all spending
Total Claims
4K
Providers
9
Avg Cost/Claim
$4
National Cost Distribution
How much do providers bill per claim for S4991? Based on 4 providers billing this code nationally.
Median
$0.05
Average
$12.00
Std Dev
$23.93
Max
$47.90
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.00 and $12.05 per claim for this code.
90% bill between $0.00 and $33.56.
Top 1% bill above $46.47.
About This Procedure
HCPCS code S4991 was billed by 9 providers across 4K claims, totaling $15K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$0.05
Providers Billing
4
National Spending
$15K
Avg/Median Ratio
240.00×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for S4991
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1215240643 | $15K |
| 2 | 1528006103 | $31 |
| 3 | 1598708513 | $9 |
| 4 | 1619914785 | $0 |
| 5 | 1275570376 | $0 |
| 6 | 1194762294 | $0 |
| 7 | 1154378859 | $0 |
| 8 | 1376876664 | $0 |
| 9 | 1346291648 | $0 |
Showing top 9 of 9 providers billing this code