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#3307 of 11K

99080

HCPCS Procedure Code

HCPCS code 99080 is the #3,307 most-billed Medicaid procedure code, with $2.0M in payments across 1.5M claims from 2018–2024. The national median cost per claim is $6.15. Costs vary widely — the 90th percentile is $58.44 per claim, 9.5× the median.

Total Paid

$2.0M

0.00% of all spending

Total Claims

1.5M

Providers

1K

Avg Cost/Claim

$1

National Cost Distribution

How much do providers bill per claim for 99080? Based on 168 providers billing this code nationally.

Median

$6.15

Average

$22.14

Std Dev

$40.09

Max

$200.00

Percentile Distribution (Cost per Claim)

p10
$0.01
p25
$0.69
Median
$6.15
p75
$25.00
p90
$58.44
p95
$86.50
p99
$200.00

50% of providers bill between $0.69 and $25.00 per claim for this code.

90% bill between $0.01 and $58.44.

Top 1% bill above $200.00.

About This Procedure

HCPCS code 99080 was billed by 1K providers across 1.5M claims, totaling $2.0M in Medicaid payments from 2018–2024. This code was used for 664K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.15

Providers Billing

168

National Spending

$2.0M

Avg/Median Ratio

3.60×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 99080

#ProviderTotal Paid
1Prisma Health University Medical Group

Greenville, SC · Internal Medicine

$511K
21588730360$191K
31447229281$133K
4Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$104K
5Valley Behavioral Health Incorporated

Salt Lake City, UT · Psychiatry & Neurology Psychiatry

$103K
61568576056$81K
71750624680$59K
81538402458$44K
91861568594$42K
101720321656$41K
111477590263$40K
121205179132$34K
131306800909$34K
141649225632$33K
151407199326$29K
161174579114$24K
171205205630$23K
181831107440$22K
191083669055$20K
201497805618$20K

Showing top 20 of 1K providers billing this code