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#3637 of 11K

S0257

HCPCS Procedure Code

HCPCS code S0257 is the #3,637 most-billed Medicaid procedure code, with $1.4M in payments across 73K claims from 2018–2024. The national median cost per claim is $0.30. Costs vary widely — the 90th percentile is $83.36 per claim, 277.9× the median.

Total Paid

$1.4M

0.00% of all spending

Total Claims

73K

Providers

150

Avg Cost/Claim

$19

National Cost Distribution

How much do providers bill per claim for S0257? Based on 37 providers billing this code nationally.

Median

$0.30

Average

$14.25

Std Dev

$31.52

Max

$97.89

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.02
Median
$0.30
p75
$1.55
p90
$83.36
p95
$92.52
p99
$97.63

50% of providers bill between $0.02 and $1.55 per claim for this code.

90% bill between $0.00 and $83.36.

Top 1% bill above $97.63.

About This Procedure

HCPCS code S0257 was billed by 150 providers across 73K claims, totaling $1.4M in Medicaid payments from 2018–2024. This code was used for 59K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.30

Providers Billing

37

National Spending

$1.4M

Avg/Median Ratio

47.50×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for S0257

#ProviderTotal Paid
11265095582$628K
21063958155$363K
31750946646$349K
41568573442$24K
51861833386$23K
61902099708$3K
71073779658$2K
81033389606$571
91598953721$551
101487045530$530
111033165345$435
121689009854$320
131821243759$315
141942307681$240
151972528032$128
161912097734$124
171861719122$121
181154733632$100
191083931919$92
201366082166$90

Showing top 20 of 150 providers billing this code

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