99226
HCPCS Procedure Code
HCPCS code 99226 is the #2,283 most-billed Medicaid procedure code, with $7.1M in payments across 123K claims from 2018–2024. The national median cost per claim is $34.09.
Total Paid
$7.1M
0.00% of all spending
Total Claims
123K
Providers
322
Avg Cost/Claim
$58
National Cost Distribution
How much do providers bill per claim for 99226? Based on 311 providers billing this code nationally.
Median
$34.09
Average
$39.99
Std Dev
$38.45
Max
$565.46
Percentile Distribution (Cost per Claim)
50% of providers bill between $20.87 and $52.35 per claim for this code.
90% bill between $11.38 and $66.95.
Top 1% bill above $109.41.
About This Procedure
HCPCS code 99226 was billed by 322 providers across 123K claims, totaling $7.1M in Medicaid payments from 2018–2024. This code was used for 78K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$34.09
Providers Billing
311
National Spending
$7.1M
Avg/Median Ratio
1.17×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 99226
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1982795639 | $2.8M |
| 2 | 1083008072 | $544K |
| 3 | 1124374822 | $404K |
| 4 | 1487666277 | $207K |
| 5 | Medstar Medical Group Ii Llc Baltimore, MD · General Practice | $132K |
| 6 | 1780971275 | $128K |
| 7 | 1497801419 | $123K |
| 8 | 1043278351 | $103K |
| 9 | 1932492626 | $91K |
| 10 | Reliant Physicians (Kumar) Pllc Las Vegas, NV · Hospitalist | $86K |
| 11 | Aurora Medical Group, Inc. Milwaukee, WI · Internal Medicine | $75K |
| 12 | 1326485285 | $70K |
| 13 | 1922598929 | $67K |
| 14 | 1063419943 | $66K |
| 15 | 1477554814 | $62K |
| 16 | 1689799579 | $57K |
| 17 | 1598718256 | $57K |
| 18 | 1093057200 | $51K |
| 19 | 1619504735 | $50K |
| 20 | 1184832040 | $50K |
Showing top 20 of 322 providers billing this code