Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#903 of 11K

S9430

HCPCS Procedure Code

HCPCS code S9430 is the #903 most-billed Medicaid procedure code, with $60.8M in payments across 221K claims from 2018–2024. The national median cost per claim is $42.75. Costs vary widely — the 90th percentile is $143.74 per claim, 3.4× the median.

Total Paid

$60.8M

0.01% of all spending

Total Claims

221K

Providers

98

Avg Cost/Claim

$276

National Cost Distribution

How much do providers bill per claim for S9430? Based on 56 providers billing this code nationally.

Median

$42.75

Average

$268.85

Std Dev

$864.96

Max

$4,104.84

Percentile Distribution (Cost per Claim)

p10
$20.27
p25
$24.99
Median
$42.75
p75
$79.61
p90
$143.74
p95
$1,448.44
p99
$3,996.18

50% of providers bill between $24.99 and $79.61 per claim for this code.

90% bill between $20.27 and $143.74.

Top 1% bill above $3,996.18.

About This Procedure

HCPCS code S9430 was billed by 98 providers across 221K claims, totaling $60.8M in Medicaid payments from 2018–2024. This code was used for 192K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$42.75

Providers Billing

56

National Spending

$60.8M

Avg/Median Ratio

6.29×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for S9430

#ProviderTotal Paid
1Washington Institute For Coagulation

Seattle, WA · Pharmacy, Specialty Pharmacy

$20.2M
2Mississippi Band Of Choctaw Indians

Choctaw, MS · General Acute Care Hospital

$12.2M
31053799403$11.3M
41083700686$6.3M
51477708469$5.4M
61881915031$1.8M
71104822931$1.2M
81790902906$742K
91053311860$326K
101417355579$227K
111255647806$217K
121972688919$164K
131245206507$109K
141346226750$102K
151922105154$62K
161184774796$47K
171871783753$41K
181255401477$38K
191073839114$33K
201396049706$28K

Showing top 20 of 98 providers billing this code