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

#694 of 11K

S9976

HCPCS Procedure Code

HCPCS code S9976 is the #694 most-billed Medicaid procedure code, with $103.3M in payments across 1.8M claims from 2018–2024. The national median cost per claim is $64.43. Costs vary widely — the 90th percentile is $211.80 per claim, 3.3× the median.

Total Paid

$103.3M

0.01% of all spending

Total Claims

1.8M

Providers

100

Avg Cost/Claim

$58

National Cost Distribution

How much do providers bill per claim for S9976? Based on 99 providers billing this code nationally.

Median

$64.43

Average

$112.91

Std Dev

$150.13

Max

$1,157.76

Percentile Distribution (Cost per Claim)

p10
$27.00
p25
$28.68
Median
$64.43
p75
$143.28
p90
$211.80
p95
$299.85
p99
$620.66

50% of providers bill between $28.68 and $143.28 per claim for this code.

90% bill between $27.00 and $211.80.

Top 1% bill above $620.66.

About This Procedure

HCPCS code S9976 was billed by 100 providers across 1.8M claims, totaling $103.3M in Medicaid payments from 2018–2024. This code was used for 294K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$64.43

Providers Billing

99

National Spending

$103.3M

Avg/Median Ratio

1.75×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for S9976

#ProviderTotal Paid
11750363305$7.7M
21841325172$5.2M
31235478363$4.6M
41639201262$4.6M
51558493916$4.4M
61700987591$4.2M
71851457451$3.8M
81366659906$3.3M
91629330691$2.7M
101851623169$2.6M
111861747578$2.6M
121003247362$2.5M
131750791505$2.4M
14Community Mental Health Authority Of Clinton Eaton Ingham Counties

Lansing, MI · Clinic/Center Mental Health (Including Community Mental Health Center)

$2.3M
151831651330$2.3M
161962551648$2.2M
171346393683$2.2M
181508010679$2.0M
191023482825$1.8M
201457686230$1.7M

Showing top 20 of 100 providers billing this code