S9986
HCPCS Procedure Code
HCPCS code S9986 is the #5,511 most-billed Medicaid procedure code, with $184K in payments across 25K claims from 2018–2024. The national median cost per claim is $2.86. Costs vary widely — the 90th percentile is $24.60 per claim, 8.6× the median.
Total Paid
$184K
0.00% of all spending
Total Claims
25K
Providers
104
Avg Cost/Claim
$7
National Cost Distribution
How much do providers bill per claim for S9986? Based on 16 providers billing this code nationally.
Median
$2.86
Average
$12.91
Std Dev
$31.14
Max
$124.98
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.64 and $6.02 per claim for this code.
90% bill between $0.01 and $24.60.
Top 1% bill above $111.52.
About This Procedure
HCPCS code S9986 was billed by 104 providers across 25K claims, totaling $184K in Medicaid payments from 2018–2024. This code was used for 23K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$2.86
Providers Billing
16
National Spending
$184K
Avg/Median Ratio
4.51×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for S9986
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1083073050 | $105K |
| 2 | 1164972485 | $75K |
| 3 | 1326251711 | $1K |
| 4 | 1134696677 | $1K |
| 5 | 1336355627 | $975 |
| 6 | 1073537221 | $448 |
| 7 | 1912954983 | $384 |
| 8 | 1518434067 | $192 |
| 9 | 1477020923 | $102 |
| 10 | 1881161321 | $77 |
| 11 | Premier Eye Care Of Florida Llc Coral Gables, FL · Exclusive Provider Organization | $75 |
| 12 | 1710118674 | $56 |
| 13 | 1215977822 | $51 |
| 14 | 1003998451 | $7 |
| 15 | 1063957249 | $0 |
| 16 | 1184658577 | $0 |
| 17 | 1215281944 | $0 |
| 18 | 1851152565 | $0 |
| 19 | 1437191061 | $0 |
| 20 | 1235135807 | $0 |
Showing top 20 of 104 providers billing this code