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HCPCS S0117 Fee Schedule

Last Verified: December 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Tretinoin, topical, 5 grams
Key FactDetail
Service Type

Temporary National Codes (Non-Medicare)

Non-Medicare Drug Codes

Common Place of Service

None

11 - Office

Complexity LevelLow

National average reimbursement for HCPCS S0117 by major payers:

bcbs

$4.74

uhc

$3.89

aetna

$3.93

cigna

$3.24

Preview provider-level rates for...
For billing codeHCPCS S0117
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS S0117

United
S0117$3.751760435408 - JULIE STAUB930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONSORPhysical Therapist (225100000X)
United
S0117$3.751558591768 - ASHLEY RIGGS930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONSORPhysical Therapist (225100000X)
United
S0117$3.751902212863 - JOAN HARVEY930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONSORAcute Care Nurse Practitioner (363LA2100X)
United
S0117$3.751083994396 - TODD MORSE930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONSORPhysical Therapist (225100000X)
United
S0117$3.791598793036 - DANIEL ZIMMERMAN861441258OKPhysician Assistant (363A00000X)
United
S0117$3.751841762002 - CAITLIN MYERS930963546 - (OR) HIV ALLIANCEORFamily Medicine Physician (207Q00000X)
United
S0117$3.751245391192 - JONELL BLASE931251530ORFamily Nurse Practitioner (363LF0000X)
United
S0117$3.751811205248 - KATHERINE SCHOONOVER832849989 - ZOOMCAREORFamily Nurse Practitioner (363LF0000X)
United
S0117$3.791598793036 - DANIEL ZIMMERMAN861441258NCPhysician Assistant (363A00000X)
United
S0117$3.751033388137 - TRAVIS HOFFMAN930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONSOROccupational Therapist (225X00000X)
United
S0117$3.751659341386 - LEO CYTRYNBAUM930975147 - PEACEHEALTHORHospitalist Physician (208M00000X)
United
S0117$3.751124242086 - KATHY MELDRUM930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONSORPhysical Therapist (225100000X)
United
S0117$3.751962763185 - CELIA CHEUNG930593500 - (OR) DOCTORS EMERGENCY ROOM CORP PCOREmergency Medicine Physician (207P00000X)
United
S0117$3.751942629126 - AMBER VESTER931173927ORFamily Medicine Physician (207Q00000X)
United
S0117$3.821710992433 - HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE, JEFFERSON HOSPITAL581309961 - (GA) HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLEGAGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS S0117 vs. Other Non-Medicare Drug Codes Codes

The HCPCS S0117 code is part of the Temporary National Codes (Non-Medicare) services used for Non-Medicare Drug Codes. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS S0117 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
S0109-HCPCSLowMethadone, oral, 5 mg
S0117-HCPCSLowTretinoin, topical, 5 grams
S0119-HCPCSLowOndansetron, oral, 4 mg (for circumstances falling under the Medicare statute, use HCPCS Q code)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S0117. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the S0117 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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