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

#2057 of 11K

S9460

HCPCS Procedure Code

HCPCS code S9460 is the #2,057 most-billed Medicaid procedure code, with $9.6M in payments across 52K claims from 2018–2024. The national median cost per claim is $97.87. Costs vary widely — the 90th percentile is $529.98 per claim, 5.4× the median.

Total Paid

$9.6M

0.00% of all spending

Total Claims

52K

Providers

11

Avg Cost/Claim

$186

National Cost Distribution

How much do providers bill per claim for S9460? Based on 10 providers billing this code nationally.

Median

$97.87

Average

$196.46

Std Dev

$218.84

Max

$597.40

Percentile Distribution (Cost per Claim)

p10
$19.21
p25
$57.19
Median
$97.87
p75
$315.42
p90
$529.98
p95
$563.69
p99
$590.66

50% of providers bill between $57.19 and $315.42 per claim for this code.

90% bill between $19.21 and $529.98.

Top 1% bill above $590.66.

About This Procedure

HCPCS code S9460 was billed by 11 providers across 52K claims, totaling $9.6M in Medicaid payments from 2018–2024. This code was used for 6K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$97.87

Providers Billing

10

National Spending

$9.6M

Avg/Median Ratio

2.01×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for S9460

#ProviderTotal Paid
11326033788$3.4M
21154374775$2.2M
31780209882$1.5M
41174095822$1.4M
51376093211$957K
61720187362$45K
71104906569$19K
81528345519$3K
91205859691$2K
10Optum Women's And Children's Health, Llc

Marietta, GA · Home Health

$90
111740390756$0

Showing top 11 of 11 providers billing this code