99225
HCPCS Procedure Code
HCPCS code 99225 is the #2,565 most-billed Medicaid procedure code, with $4.9M in payments across 205K claims from 2018–2024. The national median cost per claim is $20.96. Costs vary widely — the 90th percentile is $50.38 per claim, 2.4× the median.
Total Paid
$4.9M
0.00% of all spending
Total Claims
205K
Providers
501
Avg Cost/Claim
$24
National Cost Distribution
How much do providers bill per claim for 99225? Based on 481 providers billing this code nationally.
Median
$20.96
Average
$26.41
Std Dev
$21.72
Max
$286.23
Percentile Distribution (Cost per Claim)
50% of providers bill between $12.97 and $35.21 per claim for this code.
90% bill between $7.09 and $50.38.
Top 1% bill above $87.66.
About This Procedure
HCPCS code 99225 was billed by 501 providers across 205K claims, totaling $4.9M in Medicaid payments from 2018–2024. This code was used for 123K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$20.96
Providers Billing
481
National Spending
$4.9M
Avg/Median Ratio
1.26×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 99225
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1710959135 | $454K |
| 2 | 1972704179 | $262K |
| 3 | 1356689996 | $201K |
| 4 | 1083008072 | $193K |
| 5 | 1053607143 | $150K |
| 6 | 1942275805 | $143K |
| 7 | 1124374822 | $140K |
| 8 | 1245474329 | $139K |
| 9 | Yale University New Haven, CT · Internal Medicine | $123K |
| 10 | 1245390855 | $106K |
| 11 | 1326485285 | $105K |
| 12 | 1063419943 | $92K |
| 13 | 1578545273 | $73K |
| 14 | 1730133992 | $71K |
| 15 | Lsu Health Sciences Center Shreveport Faculty Group Practice Shreveport, LA · Oral & Maxillofacial Surgery | $69K |
| 16 | 1356361976 | $65K |
| 17 | 1891797148 | $63K |
| 18 | 1538582945 | $54K |
| 19 | 1275553463 | $50K |
| 20 | Cook Children's Physician Network Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.) | $48K |
Showing top 20 of 501 providers billing this code