#2807 of 11K

01999

HCPCS Procedure Code

HCPCS code 01999 is the #2,807 most-billed Medicaid procedure code, with $3.5M in payments across 101K claims from 2018–2024. The national median cost per claim is $15.72. Costs vary widely — the 90th percentile is $120.54 per claim, 7.7× the median.

Total Paid

$3.5M

0.00% of all spending

Total Claims

101K

Providers

Avg Cost/Claim

$35

National Cost Distribution

How much do providers bill per claim for 01999? Based on 48 providers billing this code nationally.

Median

$15.72

Average

$49.97

Std Dev

$92.90

Max

$410.62

Percentile Distribution (Cost per Claim)

p10

$2.16

p25

$4.41

Median

$15.72

p75

$42.88

p90

$120.54

p95

$265.81

p99

$402.51

50% of providers bill between $4.41 and $42.88 per claim for this code.

90% bill between $2.16 and $120.54.

Top 1% bill above $402.51.

About This Procedure

HCPCS code 01999 was billed by 57 providers across 101K claims, totaling $3.5M in Medicaid payments from 2018–2024. This code was used for 87K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$15.72

Providers Billing

National Spending

$3.5M

Avg/Median Ratio

3.18×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 01999

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Adventist Health System-sunbelt Inc Orlando, FL · Clinical Medical Laboratory	$941K	$393.37	25.0× median	Top 10%
2	Adventist Health System-sunbelt, Inc Orlando, FL · Ambulance, Land Transport	$723K	$40.60	2.6× median	Above Median
3	1801168786	$322K	$302.85	19.3× median	Top 10%
4	1821186313	$244K	$22.76	1.4× median	Above Median
5	1740772268	$193K	$73.78	4.7× median	Above 75th
6	Orlando Health Inc. Orlando, FL · General Acute Care Hospital	$164K	$17.01	1.1× median	Above Median
7	1922032424	$159K	$11.12	0.7× median	Below Median
8	1215444054	$130K	$77.05	4.9× median	Above 75th
9	1457458986	$88K	$44.24	2.8× median	Above 75th
10	1134766694	$83K	$49.03	3.1× median	Above 75th
11	1053321919	$52K	$13.43	0.9× median	Below Median
12	Offor Med, Inc. Worthington, OH · Anesthesiology	$46K	$410.62	26.1× median	Top 1%
13	1427068345	$46K	$24.43	1.6× median	Above Median
14	Variety Children's Hospital Miami, FL · General Acute Care Hospital Children	$40K	$104.02	6.6× median	Above 75th
15	1801457510	$38K	$15.86	1.0× median	Above Median
16	1720078041	$37K	$24.96	1.6× median	Above Median
17	1346354677	$27K	$14.07	0.9× median	Below Median
18	1679678486	$22K	$16.50	1.0× median	Above Median
19	1649367269	$20K	$15.59	1.0× median	Below Median
20	University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital	$19K	$11.42	0.7× median	Below Median

Showing top 20 of 57 providers billing this code

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