#4456 of 11K

99155

HCPCS Procedure Code

HCPCS code 99155 is the #4,456 most-billed Medicaid procedure code, with $581K in payments across 18K claims from 2018–2024. The national median cost per claim is $66.65.

Total Paid

$581K

0.00% of all spending

Total Claims

18K

Providers

Avg Cost/Claim

$33

National Cost Distribution

How much do providers bill per claim for 99155? Based on 36 providers billing this code nationally.

Median

$66.65

Average

$65.06

Std Dev

$42.97

Max

$148.89

Percentile Distribution (Cost per Claim)

p10

$2.42

p25

$42.40

Median

$66.65

p75

$92.62

p90

$132.85

p95

$142.33

p99

$148.45

50% of providers bill between $42.40 and $92.62 per claim for this code.

90% bill between $2.42 and $132.85.

Top 1% bill above $148.45.

About This Procedure

HCPCS code 99155 was billed by 38 providers across 18K claims, totaling $581K in Medicaid payments from 2018–2024. This code was used for 16K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$66.65

Providers Billing

National Spending

$581K

Avg/Median Ratio

0.98×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99155

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care	$127K	$147.63	2.2× median	Top 10%
2	Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital	$110K	$92.59	1.4× median	Above Median
3	Norton Hospitals Inc Louisville, KY · General Acute Care Hospital	$46K	$23.37	0.4× median	Below Median
4	1740574573	$43K	$57.63	0.9× median	Below Median
5	Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital	$34K	$33.92	0.5× median	Below Median
6	1972683597	$24K	$79.08	1.2× median	Above Median
7	Texas Children's Physician Group Houston, TX · Pediatrics	$21K	$78.34	1.2× median	Above Median
8	1205939568	$19K	$62.53	0.9× median	Below Median
9	1801869250	$16K	$148.89	2.2× median	Top 1%
10	Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry	$16K	$2.53	0.0× median	Below Median
11	Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent	$15K	$45.23	0.7× median	Below Median
12	1295461275	$13K	$70.78	1.1× median	Above Median
13	1477537892	$13K	$88.22	1.3× median	Above Median
14	1811920549	$11K	$48.51	0.7× median	Below Median
15	1417961137	$11K	$47.83	0.7× median	Below Median
16	Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children	$9K	$92.73	1.4× median	Above 75th
17	1457389033	$9K	$73.30	1.1× median	Above Median
18	1043218944	$8K	$140.57	2.1× median	Top 10%
19	1164484432	$8K	$95.33	1.4× median	Above 75th
20	1114022431	$7K	$97.14	1.5× median	Above 75th

Showing top 20 of 38 providers billing this code

Related Procedures

99152$37.0M 99153$8.8M 99156$4.0M 99157$3.5M 99151$81K

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