#1466 of 11K

99234

HCPCS Procedure Code

HCPCS code 99234 is the #1,466 most-billed Medicaid procedure code, with $22.3M in payments across 339K claims from 2018–2024. The national median cost per claim is $80.89.

Total Paid

$22.3M

0.00% of all spending

Total Claims

339K

Providers

599

Avg Cost/Claim

$66

National Cost Distribution

How much do providers bill per claim for 99234? Based on 576 providers billing this code nationally.

Median

$80.89

Average

$80.05

Std Dev

$73.88

Max

$1,374.47

Percentile Distribution (Cost per Claim)

p10

$27.61

p25

$56.35

Median

$80.89

p75

$94.97

p90

$107.45

p95

$117.50

p99

$277.64

50% of providers bill between $56.35 and $94.97 per claim for this code.

90% bill between $27.61 and $107.45.

Top 1% bill above $277.64.

About This Procedure

HCPCS code 99234 was billed by 599 providers across 339K claims, totaling $22.3M in Medicaid payments from 2018–2024. This code was used for 262K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$80.89

Providers Billing

576

National Spending

$22.3M

Avg/Median Ratio

0.99×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99234

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1770679201	$581K	$364.53	4.5× median	Top 1%
2	1134360779	$571K	$89.30	1.1× median	Above Median
3	1588740559	$566K	$90.83	1.1× median	Above Median
4	1699212175	$538K	$53.20	0.7× median	Below Median
5	1114562261	$454K	$89.71	1.1× median	Above Median
6	1285296731	$451K	$93.77	1.2× median	Above Median
7	1376796748	$433K	$95.50	1.2× median	Above 75th
8	1043344237	$368K	$93.59	1.2× median	Above Median
9	1528016938	$356K	$101.39	1.3× median	Above 75th
10	1386160265	$339K	$91.72	1.1× median	Above Median
11	1679809917	$330K	$78.97	1.0× median	Below Median
12	1376710988	$320K	$96.05	1.2× median	Above 75th
13	1407813660	$308K	$33.96	0.4× median	Below Median
14	1144276882	$304K	$64.49	0.8× median	Below Median
15	1033372909	$276K	$90.26	1.1× median	Above Median
16	1841781135	$262K	$89.83	1.1× median	Above Median
17	Englewood Hospital And Medical Center Englewood, NJ · General Acute Care Hospital	$259K	$141.55	1.7× median	Top 10%
18	1295960268	$254K	$94.52	1.2× median	Above Median
19	1720569973	$249K	$91.75	1.1× median	Above Median
20	Carilion Medical Center Roanoke, VA · General Acute Care Hospital	$241K	$20.55	0.3× median	Below Median

Showing top 20 of 599 providers billing this code

Related Procedures

99232Subsequent hospital care, per day, moderate complexity$2.93B 99233Subsequent hospital care, per day, high complexity$2.61B 99239Hospital discharge day management, more than 30 minutes$464.1M 99244Office or other outpatient consultation, moderate complexity$402.7M 99238Hospital discharge day management, 30 minutes or less$402.6M

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