99157
HCPCS Procedure Code
HCPCS code 99157 is the #2,812 most-billed Medicaid procedure code, with $3.5M in payments across 63K claims from 2018–2024. The national median cost per claim is $65.75. Costs vary widely — the 90th percentile is $184.25 per claim, 2.8× the median.
Total Paid
$3.5M
0.00% of all spending
Total Claims
63K
Providers
117
Avg Cost/Claim
$56
National Cost Distribution
How much do providers bill per claim for 99157? Based on 98 providers billing this code nationally.
Median
$65.75
Average
$82.36
Std Dev
$81.14
Max
$422.64
Percentile Distribution (Cost per Claim)
50% of providers bill between $12.98 and $118.25 per claim for this code.
90% bill between $1.88 and $184.25.
Top 1% bill above $308.82.
About This Procedure
HCPCS code 99157 was billed by 117 providers across 63K claims, totaling $3.5M in Medicaid payments from 2018–2024. This code was used for 55K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$65.75
Providers Billing
98
National Spending
$3.5M
Avg/Median Ratio
1.25×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 99157
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1740574573 | $380K |
| 2 | 1477537892 | $356K |
| 3 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $284K |
| 4 | 1821078882 | $270K |
| 5 | 1003856774 | $245K |
| 6 | 1972683597 | $184K |
| 7 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $130K |
| 8 | Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital | $109K |
| 9 | William Beaumont Hospital Royal Oak, MI · Internal Medicine, Cardiovascular Disease | $102K |
| 10 | 1538421086 | $92K |
| 11 | 1043218944 | $82K |
| 12 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $81K |
| 13 | 1841797743 | $80K |
| 14 | 1053300541 | $79K |
| 15 | 1255712584 | $69K |
| 16 | Texas Children's Physician Group Houston, TX · Pediatrics | $66K |
| 17 | 1417961137 | $62K |
| 18 | 1811920549 | $59K |
| 19 | 1457389033 | $58K |
| 20 | 1740403658 | $49K |
Showing top 20 of 117 providers billing this code