S0164
HCPCS Procedure Code
HCPCS code S0164 is the #4,093 most-billed Medicaid procedure code, with $858K in payments across 77K claims from 2018–2024. The national median cost per claim is $8.03. Costs vary widely — the 90th percentile is $17.20 per claim, 2.1× the median.
Total Paid
$858K
0.00% of all spending
Total Claims
77K
Providers
219
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for S0164? Based on 194 providers billing this code nationally.
Median
$8.03
Average
$11.70
Std Dev
$33.30
Max
$448.41
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.32 and $11.81 per claim for this code.
90% bill between $0.49 and $17.20.
Top 1% bill above $76.40.
About This Procedure
HCPCS code S0164 was billed by 219 providers across 77K claims, totaling $858K in Medicaid payments from 2018–2024. This code was used for 55K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$8.03
Providers Billing
194
National Spending
$858K
Avg/Median Ratio
1.46×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for S0164
| # | Provider | Total Paid |
|---|---|---|
| 1 | Alaska Native Tribal Health Consortium Anchorage, AK · General Acute Care Hospital | $252K |
| 2 | 1831188275 | $73K |
| 3 | Mcallen Hospitals L P Edinburg, TX · General Acute Care Hospital | $56K |
| 4 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $26K |
| 5 | 1396731105 | $23K |
| 6 | 1811946734 | $22K |
| 7 | 1295181477 | $19K |
| 8 | 1215927470 | $19K |
| 9 | 1467808659 | $19K |
| 10 | 1710109186 | $14K |
| 11 | 1366896300 | $13K |
| 12 | 1063495190 | $13K |
| 13 | 1902844988 | $10K |
| 14 | Grossmont Hospital Corporation La Mesa, CA · General Acute Care Hospital | $9K |
| 15 | 1952476665 | $8K |
| 16 | 1699129601 | $8K |
| 17 | 1750384079 | $8K |
| 18 | 1558575746 | $8K |
| 19 | 1104856095 | $8K |
| 20 | 1205089026 | $8K |
Showing top 20 of 219 providers billing this code