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#4442 of 11K

S5498

HCPCS Procedure Code

HCPCS code S5498 is the #4,442 most-billed Medicaid procedure code, with $588K in payments across 23K claims from 2018–2024. The national median cost per claim is $28.30. Costs vary widely — the 90th percentile is $102.07 per claim, 3.6× the median.

Total Paid

$588K

0.00% of all spending

Total Claims

23K

Providers

14

Avg Cost/Claim

$26

National Cost Distribution

How much do providers bill per claim for S5498? Based on 14 providers billing this code nationally.

Median

$28.30

Average

$48.59

Std Dev

$46.69

Max

$164.69

Percentile Distribution (Cost per Claim)

p10
$10.62
p25
$17.56
Median
$28.30
p75
$77.17
p90
$102.07
p95
$128.43
p99
$157.44

50% of providers bill between $17.56 and $77.17 per claim for this code.

90% bill between $10.62 and $102.07.

Top 1% bill above $157.44.

About This Procedure

HCPCS code S5498 was billed by 14 providers across 23K claims, totaling $588K in Medicaid payments from 2018–2024. This code was used for 7,145 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$28.30

Providers Billing

14

National Spending

$588K

Avg/Median Ratio

1.72×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for S5498

#ProviderTotal Paid
11326096629$169K
21235209081$142K
31427132265$116K
41760425011$77K
51831241033$58K
61508890450$8K
71619478047$7K
81013919240$3K
91346210549$2K
101568474716$2K
111033166244$1K
12Optum Infusion Services 308 Llc

Chandler, AZ · Pharmacy Home Infusion Therapy Pharmacy

$1K
131457658486$1K
141033531538$773

Showing top 14 of 14 providers billing this code