99153
HCPCS Procedure Code
HCPCS code 99153 is the #2,116 most-billed Medicaid procedure code, with $8.8M in payments across 763K claims from 2018–2024. The national median cost per claim is $5.60. Costs vary widely — the 90th percentile is $22.60 per claim, 4.0× the median.
Total Paid
$8.8M
0.00% of all spending
Total Claims
763K
Providers
1,379
Avg Cost/Claim
$12
National Cost Distribution
How much do providers bill per claim for 99153? Based on 1,145 providers billing this code nationally.
Median
$5.60
Average
$13.43
Std Dev
$63.52
Max
$1,626.24
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.77 and $11.91 per claim for this code.
90% bill between $0.25 and $22.60.
Top 1% bill above $113.95.
About This Procedure
HCPCS code 99153 was billed by 1,379 providers across 763K claims, totaling $8.8M in Medicaid payments from 2018–2024. This code was used for 653K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$5.60
Providers Billing
1,145
National Spending
$8.8M
Avg/Median Ratio
2.40×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 99153
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1205835485 | $946K |
| 2 | 1710164504 | $639K |
| 3 | 1548222912 | $436K |
| 4 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $352K |
| 5 | Providence Health & Services Washington Anchorage, AK · General Acute Care Hospital | $273K |
| 6 | 1356925960 | $253K |
| 7 | 1477287290 | $190K |
| 8 | 1477569838 | $161K |
| 9 | 1962987677 | $139K |
| 10 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $134K |
| 11 | University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program | $132K |
| 12 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $120K |
| 13 | 1306914213 | $114K |
| 14 | 1639610389 | $113K |
| 15 | 1265982375 | $110K |
| 16 | 1073929121 | $101K |
| 17 | 1114081056 | $101K |
| 18 | Bakersfield Memorial Hospital Bakersfield, CA · General Acute Care Hospital | $97K |
| 19 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $97K |
| 20 | Ahs Hospital Corp. Morristown, NJ · General Acute Care Hospital | $92K |
Showing top 20 of 1,379 providers billing this code