Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#3991 of 11K

84999

HCPCS Procedure Code

HCPCS code 84999 is the #3,991 most-billed Medicaid procedure code, with $950K in payments across 75K claims from 2018–2024. The national median cost per claim is $5.23. Costs vary widely — the 90th percentile is $98.35 per claim, 18.8× the median.

Total Paid

$950K

0.00% of all spending

Total Claims

75K

Providers

67

Avg Cost/Claim

$13

National Cost Distribution

How much do providers bill per claim for 84999? Based on 48 providers billing this code nationally.

Median

$5.23

Average

$34.81

Std Dev

$84.26

Max

$492.94

Percentile Distribution (Cost per Claim)

p10
$0.20
p25
$1.92
Median
$5.23
p75
$20.07
p90
$98.35
p95
$138.20
p99
$388.33

50% of providers bill between $1.92 and $20.07 per claim for this code.

90% bill between $0.20 and $98.35.

Top 1% bill above $388.33.

About This Procedure

HCPCS code 84999 was billed by 67 providers across 75K claims, totaling $950K in Medicaid payments from 2018–2024. This code was used for 70K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.23

Providers Billing

48

National Spending

$950K

Avg/Median Ratio

6.66×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 84999

#ProviderTotal Paid
11073642641$606K
21215003603$102K
31588663769$51K
41063441293$39K
5Laboratory Corporation Of America

San Diego, CA · Clinical Medical Laboratory

$18K
6Mayo Collaborative Services, Inc

Rochester, MN · Clinical Medical Laboratory

$18K
7Laboratory Corporation Of America

Phoenix, AZ · Clinical Medical Laboratory

$17K
8Laboratory Corporation Of America Holdings

Birmingham, AL · Clinical Medical Laboratory

$17K
91477616571$10K
10Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$7K
111679592380$6K
12Quest Diagnostics Clinical Laboratories Inc

Tucker, GA · Clinical Medical Laboratory

$6K
131356324545$4K
14Christus Santa Rosa Health Care Corporation

San Antonio, TX · General Acute Care Hospital

$4K
151861435042$4K
161578560504$4K
17Bronxcare Health System

Bronx, NY · General Acute Care Hospital

$4K
181427176569$4K
191376564641$3K
201396287082$3K

Showing top 20 of 67 providers billing this code