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#74 of 11K

99233

Subsequent hospital care, per day, high complexity

Subsequent hospital care, per day, high complexity is the #74 most-billed Medicaid procedure code, with $2.61B in payments across 57.6M claims from 2018–2024. The national median cost per claim is $35.30. Costs vary widely — the 90th percentile is $72.92 per claim, 2.1× the median.

Total Paid

$2.61B

0.24% of all spending

Total Claims

57.6M

Providers

22K

Avg Cost/Claim

$45

National Cost Distribution

How much do providers bill per claim for 99233? Based on 21K providers billing this code nationally.

Median

$35.30

Average

$41.85

Std Dev

$47.23

Max

$1,916.29

Percentile Distribution (Cost per Claim)

p10
$13.43
p25
$22.02
Median
$35.30
p75
$53.71
p90
$72.92
p95
$89.45
p99
$143.47

50% of providers bill between $22.02 and $53.71 per claim for this code.

90% bill between $13.43 and $72.92.

Top 1% bill above $143.47.

About This Procedure

HCPCS code 99233 (Subsequent hospital care, per day, high complexity) was billed by 22K providers across 57.6M claims, totaling $2.61B in Medicaid payments from 2018–2024. This code was used for 20.9M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$35.30

Providers Billing

21K

National Spending

$2.61B

Avg/Median Ratio

1.19×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99233

#ProviderTotal Paid
11124374822$27.9M
21316902208$23.9M
31861627242$18.8M
4County Of San Diego

San Diego, CA · Public Health or Welfare

$16.9M
5Medstar Medical Group Ii Llc

Baltimore, MD · General Practice

$16.5M
6Group Health Plan, Inc.

Minneapolis, MN · Clinic/Center, Multi-Specialty

$14.4M
7Los Angeles County Department Of Mental Health

Los Angeles, CA · Clinic/Center, Mental Health (Including Community Mental Health Center)

$14.3M
81083008072$11.3M
91619987302$10.9M
101952792475$10.8M
11Hennepin Healthcare System Inc

Minneapolis, MN · General Acute Care Hospital

$10.1M
121699157701$9.8M
131568758266$9.2M
141265546261$9.2M
151083647754$9.0M
16County Of Tulare

Visalia, CA · Clinic/Center Public Health State or Local

$8.9M
171750751566$8.8M
181154369510$8.7M
191023285756$8.6M
20Community Medical Associates, Inc.

Louisville, KY · Clinical Neuropsychologist

$8.5M

Showing top 20 of 22K providers billing this code