#1206 of 11K

99217

HCPCS Procedure Code

HCPCS code 99217 is the #1,206 most-billed Medicaid procedure code, with $33.4M in payments across 855K claims from 2018–2024. The national median cost per claim is $31.89.

Total Paid

$33.4M

0.00% of all spending

Total Claims

855K

Providers

Avg Cost/Claim

$39

National Cost Distribution

How much do providers bill per claim for 99217? Based on 2K providers billing this code nationally.

Median

$31.89

Average

$37.51

Std Dev

$43.52

Max

$597.44

Percentile Distribution (Cost per Claim)

p10

$12.56

p25

$21.52

Median

$31.89

p75

$42.74

p90

$56.92

p95

$66.70

p99

$216.23

50% of providers bill between $21.52 and $42.74 per claim for this code.

90% bill between $12.56 and $56.92.

Top 1% bill above $216.23.

About This Procedure

HCPCS code 99217 was billed by 2K providers across 855K claims, totaling $33.4M in Medicaid payments from 2018–2024. This code was used for 771K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$31.89

Providers Billing

National Spending

$33.4M

Avg/Median Ratio

1.18×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99217

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1124374822	$1.6M	$40.18	1.3× median	Above Median
2	Childrens Hospital Of The Kings Daughters Inc Norfolk, VA · Social Worker, Clinical	$1.1M	$578.43	18.1× median	Top 1%
3	1508873183	$1.1M	$66.67	2.1× median	Top 10%
4	Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital	$1.0M	$46.16	1.4× median	Above 75th
5	1497920524	$513K	$39.00	1.2× median	Above Median
6	1083008072	$483K	$33.69	1.1× median	Above Median
7	Cook Children's Physician Network Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.)	$399K	$56.90	1.8× median	Above 75th
8	1750751566	$354K	$45.25	1.4× median	Above 75th
9	1053361642	$351K	$372.62	11.7× median	Top 1%
10	William Beaumont Hospital Royal Oak, MI · Internal Medicine, Cardiovascular Disease	$340K	$39.22	1.2× median	Above Median
11	1871047712	$308K	$91.44	2.9× median	Top 10%
12	Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent	$298K	$36.35	1.1× median	Above Median
13	1811920549	$289K	$39.71	1.2× median	Above Median
14	1578545273	$267K	$22.77	0.7× median	Below Median
15	1093967861	$266K	$35.42	1.1× median	Above Median
16	1730451063	$260K	$39.18	1.2× median	Above Median
17	1417961137	$260K	$36.87	1.2× median	Above Median
18	1093298176	$257K	$37.63	1.2× median	Above Median
19	1265546261	$246K	$44.73	1.4× median	Above 75th
20	1366407603	$225K	$478.04	15.0× median	Top 1%

Showing top 20 of 2K providers billing this code

Related Procedures

99213Office/outpatient visit, est. patient, low-mod complexity$33.00B 99214Office/outpatient visit, est. patient, mod-high complexity$29.91B 99212Office/outpatient visit, low complexity$3.85B 99215Office/outpatient visit, high complexity$2.77B 99211Office/outpatient visit, minimal complexity$1.73B

← All procedures Top providers →