#3582 of 11K

59200

HCPCS Procedure Code

HCPCS code 59200 is the #3,582 most-billed Medicaid procedure code, with $1.5M in payments across 7,281 claims from 2018–2024. The national median cost per claim is $56.80. Costs vary widely — the 90th percentile is $375.74 per claim, 6.6× the median.

Total Paid

$1.5M

0.00% of all spending

Total Claims

7,281

Providers

Avg Cost/Claim

$201

National Cost Distribution

How much do providers bill per claim for 59200? Based on 29 providers billing this code nationally.

Median

$56.80

Average

$124.09

Std Dev

$165.02

Max

$596.25

Percentile Distribution (Cost per Claim)

p10

$22.47

p25

$27.80

Median

$56.80

p75

$88.13

p90

$375.74

p95

$508.47

p99

$585.63

50% of providers bill between $27.80 and $88.13 per claim for this code.

90% bill between $22.47 and $375.74.

Top 1% bill above $585.63.

About This Procedure

HCPCS code 59200 was billed by 30 providers across 7,281 claims, totaling $1.5M in Medicaid payments from 2018–2024. This code was used for 6,829 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$56.80

Providers Billing

National Spending

$1.5M

Avg/Median Ratio

2.18×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 59200

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1417959701	$920K	$596.25	10.5× median	Top 1%
2	1194832949	$156K	$300.47	5.3× median	Above 75th
3	Banner - University Medical Center Phoenix Phoenix, AZ · Clinic/Center, Sleep Disorder Diagnostic	$150K	$192.01	3.4× median	Above 75th
4	1033553847	$67K	$50.93	0.9× median	Below Median
5	1235363045	$26K	$76.05	1.3× median	Above Median
6	1164848453	$23K	$558.32	9.8× median	Top 10%
7	1972556942	$22K	$64.20	1.1× median	Above Median
8	1275977084	$21K	$56.80	1.0× median	Below Median
9	1518068022	$14K	$62.26	1.1× median	Above Median
10	1841366713	$12K	$22.49	0.4× median	Below Median
11	1275774333	$12K	$26.15	0.5× median	Below Median
12	1548291891	$10K	$61.51	1.1× median	Above Median
13	New York City Health And Hospitals Corporation New York, NY · Internal Medicine	$9K	$433.70	7.6× median	Top 10%
14	The Cooper Health System Camden, NJ · General Acute Care Hospital	$5K	$361.25	6.4× median	Above 75th
15	1821095779	$3K	$88.13	1.6× median	Above Median
16	1518360296	$3K	$25.12	0.4× median	Below Median
17	Boston Medical Center Corporation Boston, MA · General Acute Care Hospital	$3K	$213.25	3.8× median	Above 75th
18	1538215546	$2K	$10.33	0.2× median	Below Median
19	1750399218	$2K	$29.28	0.5× median	Below Median
20	1275569204	$1K	$38.15	0.7× median	Below Median

Showing top 20 of 30 providers billing this code

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