#4350 of 11K

S5502

HCPCS Procedure Code

HCPCS code S5502 is the #4,350 most-billed Medicaid procedure code, with $642K in payments across 18K claims from 2018–2024. The national median cost per claim is $25.28. Costs vary widely — the 90th percentile is $87.75 per claim, 3.5× the median.

Total Paid

$642K

0.00% of all spending

Total Claims

18K

Providers

Avg Cost/Claim

$36

National Cost Distribution

How much do providers bill per claim for S5502? Based on 28 providers billing this code nationally.

Median

$25.28

Average

$45.27

Std Dev

$75.33

Max

$403.49

Percentile Distribution (Cost per Claim)

p10

$5.44

p25

$12.34

Median

$25.28

p75

$43.77

p90

$87.75

p95

$94.99

p99

$320.51

50% of providers bill between $12.34 and $43.77 per claim for this code.

90% bill between $5.44 and $87.75.

Top 1% bill above $320.51.

About This Procedure

HCPCS code S5502 was billed by 28 providers across 18K claims, totaling $642K in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$25.28

Providers Billing

National Spending

$642K

Avg/Median Ratio

1.79×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for S5502

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1528070992	$165K	$85.56	3.4× median	Above 75th
2	1932266632	$163K	$38.10	1.5× median	Above Median
3	1033166244	$56K	$71.62	2.8× median	Above 75th
4	1417904574	$47K	$403.49	16.0× median	Top 1%
5	1619478047	$41K	$21.46	0.8× median	Below Median
6	1184653388	$40K	$32.00	1.3× median	Above Median
7	Optum Infusion Services 308 Llc Chandler, AZ · Pharmacy Home Infusion Therapy Pharmacy	$26K	$21.13	0.8× median	Below Median
8	1952440604	$20K	$60.79	2.4× median	Above 75th
9	1154418218	$16K	$7.50	0.3× median	Below Median
10	1164471405	$12K	$18.38	0.7× median	Below Median
11	1083793566	$8K	$96.14	3.8× median	Top 10%
12	1609314343	$8K	$92.85	3.7× median	Top 10%
13	1326096629	$6K	$7.19	0.3× median	Below Median
14	1366432122	$6K	$6.01	0.2× median	Below Median
15	1235329228	$5K	$60.99	2.4× median	Above 75th
16	1780046284	$5K	$31.36	1.2× median	Above Median
17	1881727998	$5K	$13.29	0.5× median	Below Median
18	1508890450	$4K	$33.15	1.3× median	Above Median
19	1750378436	$3K	$26.81	1.1× median	Above Median
20	1033111208	$3K	$23.75	0.9× median	Below Median

Showing top 20 of 28 providers billing this code

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S5501$2.6M S5497$830K S5498$588K

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