#2522 of 11K

S9475

HCPCS Procedure Code

HCPCS code S9475 is the #2,522 most-billed Medicaid procedure code, with $5.2M in payments across 15K claims from 2018–2024. The national median cost per claim is $410.41.

Total Paid

$5.2M

0.00% of all spending

Total Claims

15K

Providers

Avg Cost/Claim

$356

National Cost Distribution

How much do providers bill per claim for S9475? Based on 20 providers billing this code nationally.

Median

$410.41

Average

$355.52

Std Dev

$257.11

Max

$1,061.85

Percentile Distribution (Cost per Claim)

p10

$109.36

p25

$109.48

Median

$410.41

p75

$531.41

p90

$555.90

p95

$605.62

p99

$970.61

50% of providers bill between $109.48 and $531.41 per claim for this code.

90% bill between $109.36 and $555.90.

Top 1% bill above $970.61.

About This Procedure

HCPCS code S9475 was billed by 21 providers across 15K claims, totaling $5.2M in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$410.41

Providers Billing

National Spending

$5.2M

Avg/Median Ratio

0.87×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for S9475

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1679709802	$2.2M	$459.51	1.1× median	Above Median
2	1417000233	$918K	$412.01	1.0× median	Above Median
3	1184367567	$764K	$495.06	1.2× median	Above Median
4	1699548214	$283K	$536.86	1.3× median	Above 75th
5	1508069402	$229K	$1,061.85	2.6× median	Top 1%
6	1720314024	$134K	$109.48	0.3× median	Below Median
7	1437283587	$132K	$553.04	1.3× median	Above 75th
8	1457861684	$121K	$109.48	0.3× median	Below Median
9	1073513297	$69K	$108.33	0.3× median	Below Median
10	1609991504	$66K	$109.48	0.3× median	Below Median
11	1700450426	$60K	$529.59	1.3× median	Above Median
12	1609036847	$56K	$581.61	1.4× median	Top 10%
13	1578125852	$43K	$414.27	1.0× median	Above Median
14	1821796160	$37K	$408.82	1.0× median	Below Median
15	1649838590	$27K	$273.70	0.7× median	Below Median
16	1376712786	$18K	$109.48	0.3× median	Below Median
17	1083751630	$13K	$109.48	0.3× median	Below Median
18	1780720649	$7K	$547.40	1.3× median	Above 75th
19	1710364799	$6K	$180.71	0.4× median	Below Median
20	1629549779	$143	$0.31	0.0× median	Below Median

Showing top 20 of 21 providers billing this code

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