#3571 of 11K

99170

HCPCS Procedure Code

HCPCS code 99170 is the #3,571 most-billed Medicaid procedure code, with $1.5M in payments across 15K claims from 2018–2024. The national median cost per claim is $92.12. Costs vary widely — the 90th percentile is $208.62 per claim, 2.3× the median.

Total Paid

$1.5M

0.00% of all spending

Total Claims

15K

Providers

Avg Cost/Claim

$101

National Cost Distribution

How much do providers bill per claim for 99170? Based on 46 providers billing this code nationally.

Median

$92.12

Average

$111.67

Std Dev

$74.05

Max

$404.24

Percentile Distribution (Cost per Claim)

p10

$42.94

p25

$79.10

Median

$92.12

p75

$115.29

p90

$208.62

p95

$241.25

p99

$353.88

50% of providers bill between $79.10 and $115.29 per claim for this code.

90% bill between $42.94 and $208.62.

Top 1% bill above $353.88.

About This Procedure

HCPCS code 99170 was billed by 46 providers across 15K claims, totaling $1.5M in Medicaid payments from 2018–2024. This code was used for 13K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$92.12

Providers Billing

National Spending

$1.5M

Avg/Median Ratio

1.21×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99170

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital	$609K	$79.42	0.9× median	Below Median
2	Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry	$287K	$149.29	1.6× median	Above 75th
3	Rhode Island Hospital Providence, RI · General Acute Care Hospital	$125K	$195.23	2.1× median	Above 75th
4	1861420333	$90K	$247.04	2.7× median	Top 10%
5	1043260474	$67K	$100.62	1.1× median	Above Median
6	1871800177	$67K	$100.08	1.1× median	Above Median
7	1831437581	$29K	$41.36	0.4× median	Below Median
8	1982678496	$23K	$81.26	0.9× median	Below Median
9	Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital	$15K	$404.24	4.4× median	Top 1%
10	Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent	$14K	$86.11	0.9× median	Below Median
11	Driscoll Childrens Hospital Corpus Christi, TX · Speech-Language Pathologist,	$14K	$292.33	3.2× median	Top 10%
12	1417994542	$14K	$195.43	2.1× median	Above 75th
13	1306156138	$13K	$79.00	0.9× median	Below Median
14	1790718229	$12K	$112.19	1.2× median	Above Median
15	1760854624	$9K	$127.77	1.4× median	Above 75th
16	1083624738	$8K	$92.26	1.0× median	Above Median
17	1326336058	$7K	$105.03	1.1× median	Above Median
18	1144267154	$6K	$197.90	2.1× median	Above 75th
19	Suny Health Science Center At Syracuse Syracuse, NY · General Acute Care Hospital	$5K	$223.87	2.4× median	Top 10%
20	1215246749	$5K	$88.48	1.0× median	Below Median

Showing top 20 of 46 providers billing this code

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99173$87.7M 99177$18.6M 99174$7.2M 99172$2.5M 99175$4K

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