S0109
HCPCS Procedure Code
HCPCS code S0109 is the #565 most-billed Medicaid procedure code, with $144.9M in payments across 23.8M claims from 2018–2024. The national median cost per claim is $4.67. Costs vary widely — the 90th percentile is $22.79 per claim, 4.9× the median.
Total Paid
$144.9M
0.01% of all spending
Total Claims
23.8M
Providers
114
Avg Cost/Claim
$6
National Cost Distribution
How much do providers bill per claim for S0109? Based on 90 providers billing this code nationally.
Median
$4.67
Average
$17.29
Std Dev
$50.84
Max
$293.51
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.42 and $6.43 per claim for this code.
90% bill between $0.00 and $22.79.
Top 1% bill above $283.93.
About This Procedure
HCPCS code S0109 was billed by 114 providers across 23.8M claims, totaling $144.9M in Medicaid payments from 2018–2024. This code was used for 968K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$4.67
Providers Billing
90
National Spending
$144.9M
Avg/Median Ratio
3.70×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for S0109
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1710498001 | $15.3M |
| 2 | 1679926745 | $10.3M |
| 3 | 1154722361 | $10.1M |
| 4 | 1306277082 | $6.3M |
| 5 | 1609998137 | $5.5M |
| 6 | 1770944852 | $5.1M |
| 7 | 1063628170 | $4.9M |
| 8 | 1558607481 | $4.9M |
| 9 | 1003362484 | $4.9M |
| 10 | 1811035520 | $4.8M |
| 11 | 1225570195 | $4.7M |
| 12 | 1376759936 | $4.2M |
| 13 | 1366853954 | $4.2M |
| 14 | 1356854277 | $3.9M |
| 15 | 1750872966 | $3.7M |
| 16 | 1750823043 | $3.6M |
| 17 | 1932655313 | $3.0M |
| 18 | 1386783314 | $2.7M |
| 19 | 1699218669 | $2.6M |
| 20 | 1093108755 | $2.6M |
Showing top 20 of 114 providers billing this code