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#545 of 11K

S4993

HCPCS Procedure Code

HCPCS code S4993 is the #545 most-billed Medicaid procedure code, with $153.2M in payments across 1.9M claims from 2018–2024. The national median cost per claim is $46.61. Costs vary widely — the 90th percentile is $132.06 per claim, 2.8× the median.

Total Paid

$153.2M

0.01% of all spending

Total Claims

1.9M

Providers

677

Avg Cost/Claim

$80

National Cost Distribution

How much do providers bill per claim for S4993? Based on 649 providers billing this code nationally.

Median

$46.61

Average

$63.02

Std Dev

$51.32

Max

$214.65

Percentile Distribution (Cost per Claim)

p10
$8.01
p25
$17.50
Median
$46.61
p75
$102.15
p90
$132.06
p95
$158.22
p99
$197.56

50% of providers bill between $17.50 and $102.15 per claim for this code.

90% bill between $8.01 and $132.06.

Top 1% bill above $197.56.

About This Procedure

HCPCS code S4993 was billed by 677 providers across 1.9M claims, totaling $153.2M in Medicaid payments from 2018–2024. This code was used for 1.6M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$46.61

Providers Billing

649

National Spending

$153.2M

Avg/Median Ratio

1.35×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for S4993

#ProviderTotal Paid
1Planned Parenthood/orange And San Bernardino Counties, Inc.

Orange, CA · Clinic/Center, Ambulatory Family Planning Facility

$13.8M
2Planned Parenthood Of Wisconsin

Milwaukee, WI · Clinic/Center Ambulatory Family Planning Facility

$13.2M
31629057146$10.8M
41053311860$6.1M
51174633143$3.4M
61538152491$3.4M
71730435884$3.3M
81881743631$3.1M
91780859280$2.9M
101083700686$2.6M
111093989667$2.6M
121477708469$2.5M
131336174325$1.8M
141366525370$1.6M
151578738084$1.3M
161346414158$1.3M
171831363464$1.1M
181255462487$1.1M
191134297179$1.1M
201295909836$976K

Showing top 20 of 677 providers billing this code