#1093 of 11K

S0311

HCPCS Procedure Code

HCPCS code S0311 is the #1,093 most-billed Medicaid procedure code, with $41.5M in payments across 151K claims from 2018–2024. The national median cost per claim is $221.54. Costs vary widely — the 90th percentile is $579.71 per claim, 2.6× the median.

Total Paid

$41.5M

0.00% of all spending

Total Claims

151K

Providers

Avg Cost/Claim

$274

National Cost Distribution

How much do providers bill per claim for S0311? Based on 48 providers billing this code nationally.

Median

$221.54

Average

$293.74

Std Dev

$260.51

Max

$1,518.00

Percentile Distribution (Cost per Claim)

p10

$87.91

p25

$111.24

Median

$221.54

p75

$447.08

p90

$579.71

p95

$674.03

p99

$1,133.54

50% of providers bill between $111.24 and $447.08 per claim for this code.

90% bill between $87.91 and $579.71.

Top 1% bill above $1,133.54.

About This Procedure

HCPCS code S0311 was billed by 50 providers across 151K claims, totaling $41.5M in Medicaid payments from 2018–2024. This code was used for 131K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$221.54

Providers Billing

National Spending

$41.5M

Avg/Median Ratio

1.33×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for S0311

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1366807760	$20.2M	$422.24	1.9× median	Above Median
2	1639694615	$9.2M	$187.52	0.8× median	Below Median
3	1245383165	$1.6M	$527.03	2.4× median	Above 75th
4	1093137671	$1.5M	$492.62	2.2× median	Above 75th
5	1689710568	$1.2M	$187.31	0.8× median	Below Median
6	1033218565	$856K	$224.66	1.0× median	Above Median
7	1669474987	$810K	$469.30	2.1× median	Above 75th
8	1154320299	$583K	$573.70	2.6× median	Above 75th
9	1922058510	$507K	$96.52	0.4× median	Below Median
10	1013967314	$493K	$593.73	2.7× median	Top 10%
11	1710279385	$491K	$439.68	2.0× median	Above Median
12	1467414771	$382K	$177.38	0.8× median	Below Median
13	1447354089	$290K	$105.40	0.5× median	Below Median
14	1306812060	$277K	$77.07	0.3× median	Below Median
15	1841290251	$253K	$98.34	0.4× median	Below Median
16	1710971429	$241K	$125.38	0.6× median	Below Median
17	1689798787	$236K	$98.40	0.4× median	Below Median
18	1073786901	$220K	$485.40	2.2× median	Above 75th
19	1912270257	$210K	$515.51	2.3× median	Above 75th
20	1427615384	$167K	$242.31	1.1× median	Above Median

Showing top 20 of 50 providers billing this code

Related Procedures

S0302$79.6M S0317$12.0M S0316$8.7M S0310$1.5M S0315$1.3M

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