78499
HCPCS Procedure Code
HCPCS code 78499 is the #3,954 most-billed Medicaid procedure code, with $980K in payments across 3,202 claims from 2018–2024. The national median cost per claim is $131.34. Costs vary widely — the 90th percentile is $458.00 per claim, 3.5× the median.
Total Paid
$980K
0.00% of all spending
Total Claims
3,202
Providers
10
Avg Cost/Claim
$306
National Cost Distribution
How much do providers bill per claim for 78499? Based on 5 providers billing this code nationally.
Median
$131.34
Average
$208.15
Std Dev
$227.33
Max
$548.06
Percentile Distribution (Cost per Claim)
50% of providers bill between $38.20 and $322.92 per claim for this code.
90% bill between $15.43 and $458.00.
Top 1% bill above $539.05.
About This Procedure
HCPCS code 78499 was billed by 10 providers across 3,202 claims, totaling $980K in Medicaid payments from 2018–2024. This code was used for 3,087 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$131.34
Providers Billing
5
National Spending
$980K
Avg/Median Ratio
1.58×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 78499
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1376698043 | $607K |
| 2 | 1144262593 | $335K |
| 3 | 1043220650 | $30K |
| 4 | Carilion Medical Center Roanoke, VA · General Acute Care Hospital | $7K |
| 5 | 1629048012 | $15 |
| 6 | 1114025491 | $0 |
| 7 | 1043279565 | $0 |
| 8 | 1366452880 | $0 |
| 9 | 1073785259 | $0 |
| 10 | 1194749580 | $0 |
Showing top 10 of 10 providers billing this code