Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1442 of 11K

S9097

Home visit for wound care

Home visit for wound care is the #1,442 most-billed Medicaid procedure code, with $23.1M in payments across 298K claims from 2018–2024. The national median cost per claim is $65.67.

Total Paid

$23.1M

0.00% of all spending

Total Claims

298K

Providers

34

Avg Cost/Claim

$78

National Cost Distribution

How much do providers bill per claim for S9097? Based on 28 providers billing this code nationally.

Median

$65.67

Average

$190.65

Std Dev

$636.05

Max

$3,433.29

Percentile Distribution (Cost per Claim)

p10
$51.62
p25
$59.07
Median
$65.67
p75
$82.39
p90
$99.51
p95
$142.47
p99
$2,550.80

50% of providers bill between $59.07 and $82.39 per claim for this code.

90% bill between $51.62 and $99.51.

Top 1% bill above $2,550.80.

About This Procedure

HCPCS code S9097 (Home visit for wound care) was billed by 34 providers across 298K claims, totaling $23.1M in Medicaid payments from 2018–2024. This code was used for 40K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$65.67

Providers Billing

28

National Spending

$23.1M

Avg/Median Ratio

2.90×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for S9097

#ProviderTotal Paid
1Best Option Healthcare Puerto Rico Llc

San Juan, PR · Pharmacy Home Infusion Therapy Pharmacy

$8.7M
21922091107$2.5M
31275812935$2.2M
41841624178$1.3M
51063525210$1.2M
61043219553$765K
71205948817$746K
81356439905$676K
91023396231$582K
101184073058$488K
111720107956$451K
121902024326$446K
131932327665$433K
141831196955$426K
151356817217$324K
161467854877$310K
171548430689$256K
181700856846$232K
191063284115$220K
201073706644$220K

Showing top 20 of 34 providers billing this code