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#3089 of 11K

99078

HCPCS Procedure Code

HCPCS code 99078 is the #3,089 most-billed Medicaid procedure code, with $2.5M in payments across 106K claims from 2018–2024. The national median cost per claim is $25.66.

Total Paid

$2.5M

0.00% of all spending

Total Claims

106K

Providers

113

Avg Cost/Claim

$24

National Cost Distribution

How much do providers bill per claim for 99078? Based on 86 providers billing this code nationally.

Median

$25.66

Average

$46.24

Std Dev

$117.00

Max

$800.00

Percentile Distribution (Cost per Claim)

p10
$2.10
p25
$8.20
Median
$25.66
p75
$30.23
p90
$45.00
p95
$78.36
p99
$549.59

50% of providers bill between $8.20 and $30.23 per claim for this code.

90% bill between $2.10 and $45.00.

Top 1% bill above $549.59.

About This Procedure

HCPCS code 99078 was billed by 113 providers across 106K claims, totaling $2.5M in Medicaid payments from 2018–2024. This code was used for 48K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$25.66

Providers Billing

86

National Spending

$2.5M

Avg/Median Ratio

1.80×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 99078

#ProviderTotal Paid
1Contra Costa County

Martinez, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$472K
2Contra Costa County

Pittsburg, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$452K
3Contra Costa County

San Pablo, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$314K
41225421589$296K
51710945969$149K
61154401941$88K
71285923789$75K
8Contra Costa County

Concord, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$70K
91831268580$56K
10Prisma Health University Medical Group

Greenville, SC · Internal Medicine

$49K
11Contra Costa County

Antioch, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$38K
121538181482$37K
131487696191$33K
141407973043$32K
151326292731$32K
161811215742$31K
171174005011$29K
18The Toledo Hospital

Toledo, OH · Pediatrics

$28K
191386600559$23K
201528480753$22K

Showing top 20 of 113 providers billing this code