#4469 of 11K

99100

HCPCS Procedure Code

HCPCS code 99100 is the #4,469 most-billed Medicaid procedure code, with $568K in payments across 52K claims from 2018–2024. The national median cost per claim is $11.39. Costs vary widely — the 90th percentile is $61.31 per claim, 5.4× the median.

Total Paid

$568K

0.00% of all spending

Total Claims

52K

Providers

155

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for 99100? Based on 96 providers billing this code nationally.

Median

$11.39

Average

$18.93

Std Dev

$24.34

Max

$100.08

Percentile Distribution (Cost per Claim)

p10

$0.33

p25

$2.65

Median

$11.39

p75

$19.31

p90

$61.31

p95

$78.90

p99

$95.00

50% of providers bill between $2.65 and $19.31 per claim for this code.

90% bill between $0.33 and $61.31.

Top 1% bill above $95.00.

About This Procedure

HCPCS code 99100 was billed by 155 providers across 52K claims, totaling $568K in Medicaid payments from 2018–2024. This code was used for 42K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.39

Providers Billing

National Spending

$568K

Avg/Median Ratio

1.66×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 99100

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1558314427	$187K	$14.84	1.3× median	Above Median
2	1871548156	$43K	$43.60	3.8× median	Above 75th
3	1164407987	$39K	$15.54	1.4× median	Above Median
4	1952548265	$31K	$7.17	0.6× median	Below Median
5	1568893626	$31K	$39.12	3.4× median	Above 75th
6	Cook Children's Physician Network Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.)	$25K	$81.15	7.1× median	Top 10%
7	1174134969	$23K	$24.61	2.2× median	Above 75th
8	1386672798	$17K	$33.24	2.9× median	Above 75th
9	1720087802	$11K	$16.86	1.5× median	Above Median
10	1689779480	$10K	$38.59	3.4× median	Above 75th
11	Vanderbilt University Medical Center Nashville, TN · Transplant Surgery	$9K	$26.60	2.3× median	Above 75th
12	Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital	$9K	$3.53	0.3× median	Below Median
13	1861414989	$8K	$12.30	1.1× median	Above Median
14	1942488382	$7K	$13.76	1.2× median	Above Median
15	1346649415	$6K	$12.95	1.1× median	Above Median
16	Montefiore Medical Center Bronx, NY · Anesthesiology	$6K	$62.50	5.5× median	Top 10%
17	1548208564	$6K	$67.01	5.9× median	Top 10%
18	1417994872	$5K	$10.88	1.0× median	Below Median
19	1437203098	$5K	$8.74	0.8× median	Below Median
20	West Virginia University Medical Corporation Morgantown, WV · Anesthesiology	$5K	$15.22	1.3× median	Above Median

Showing top 20 of 155 providers billing this code

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