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#1654 of 11K

S9999

HCPCS Procedure Code

HCPCS code S9999 is the #1,654 most-billed Medicaid procedure code, with $16.8M in payments across 2.0M claims from 2018–2024. The national median cost per claim is $5.38. Costs vary widely — the 90th percentile is $18.07 per claim, 3.4× the median.

Total Paid

$16.8M

0.00% of all spending

Total Claims

2.0M

Providers

619

Avg Cost/Claim

$8

National Cost Distribution

How much do providers bill per claim for S9999? Based on 459 providers billing this code nationally.

Median

$5.38

Average

$12.37

Std Dev

$44.54

Max

$682.49

Percentile Distribution (Cost per Claim)

p10
$0.02
p25
$1.37
Median
$5.38
p75
$10.17
p90
$18.07
p95
$25.60
p99
$220.15

50% of providers bill between $1.37 and $10.17 per claim for this code.

90% bill between $0.02 and $18.07.

Top 1% bill above $220.15.

About This Procedure

HCPCS code S9999 was billed by 619 providers across 2.0M claims, totaling $16.8M in Medicaid payments from 2018–2024. This code was used for 1.7M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.38

Providers Billing

459

National Spending

$16.8M

Avg/Median Ratio

2.30×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for S9999

#ProviderTotal Paid
1Shield California Health Care Center Inc

Valencia, CA · Durable Medical Equipment & Medical Supplies

$3.2M
21346588225$1.3M
3The Fogarty Center

Barrington, RI · In Home Supportive Care

$1.0M
41275703084$780K
51851395271$452K
61043398407$446K
71730159617$436K
81215079678$397K
91538165642$377K
101013207109$346K
111346662160$305K
121487668927$303K
131164493003$298K
14Sequel Of New Mexico Llc

Albuquerque, NM · Residential Treatment Facility Intellectual and/or Developmental Disabilities

$298K
15At-home Personal Care Services Llc.

Santa Teresa, NM · Home Health

$279K
161902986904$264K
17New Mexico Consumer Direct Personal Care Llc

Albuquerque, NM · Home Health

$234K
181871838672$200K
191184960874$173K
201568576056$160K

Showing top 20 of 619 providers billing this code

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