#4291 of 11K

76999

HCPCS Procedure Code

HCPCS code 76999 is the #4,291 most-billed Medicaid procedure code, with $691K in payments across 12K claims from 2018–2024. The national median cost per claim is $62.29. Costs vary widely — the 90th percentile is $207.64 per claim, 3.3× the median.

Total Paid

$691K

0.00% of all spending

Total Claims

12K

Providers

Avg Cost/Claim

$57

National Cost Distribution

How much do providers bill per claim for 76999? Based on 30 providers billing this code nationally.

Median

$62.29

Average

$79.73

Std Dev

$79.49

Max

$290.26

Percentile Distribution (Cost per Claim)

p10

$6.79

p25

$28.97

Median

$62.29

p75

$88.33

p90

$207.64

p95

$268.76

p99

$286.48

50% of providers bill between $28.97 and $88.33 per claim for this code.

90% bill between $6.79 and $207.64.

Top 1% bill above $286.48.

About This Procedure

HCPCS code 76999 was billed by 36 providers across 12K claims, totaling $691K in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$62.29

Providers Billing

National Spending

$691K

Avg/Median Ratio

1.28×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 76999

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1386286979	$261K	$43.85	0.7× median	Below Median
2	The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital	$181K	$85.26	1.4× median	Above Median
3	1295181477	$72K	$258.40	4.1× median	Top 10%
4	1235162645	$22K	$120.91	1.9× median	Above 75th
5	1679879589	$21K	$277.23	4.5× median	Top 10%
6	1497185599	$21K	$35.42	0.6× median	Below Median
7	The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital	$16K	$73.46	1.2× median	Above Median
8	1740279959	$15K	$290.26	4.7× median	Top 1%
9	1689282147	$14K	$72.82	1.2× median	Above Median
10	1760862148	$11K	$19.89	0.3× median	Below Median
11	Bridgeport Hospital Bridgeport, CT · General Acute Care Hospital	$11K	$31.32	0.5× median	Below Median
12	1598193278	$11K	$14.81	0.2× median	Below Median
13	1710109186	$9K	$89.36	1.4× median	Above 75th
14	1134152549	$5K	$124.84	2.0× median	Above 75th
15	1053354233	$5K	$202.00	3.2× median	Above 75th
16	Kadlec Regional Medical Center Richland, WA · General Acute Care Hospital	$4K	$72.64	1.2× median	Above Median
17	Newyork-presbyterian-queens Flushing, NY · General Acute Care Hospital	$2K	$75.52	1.2× median	Above Median
18	Riverside Hospital Inc Newport News, VA · Psychiatric Hospital	$2K	$113.87	1.8× median	Above 75th
19	Regents Of The University Of California San Diego, CA · General Acute Care Hospital	$1K	$42.94	0.7× median	Below Median
20	Southern Baptist Hospital Of Florida Inc Jacksonville, FL · General Acute Care Hospital	$1K	$83.45	1.3× median	Above Median

Showing top 20 of 36 providers billing this code

Related Procedures

77002$11.8M 77001$2.8M 76998$2.6M 77003$1.4M

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