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#1317 of 11K

99235

HCPCS Procedure Code

HCPCS code 99235 is the #1,317 most-billed Medicaid procedure code, with $27.8M in payments across 219K claims from 2018–2024. The national median cost per claim is $110.13.

Total Paid

$27.8M

0.00% of all spending

Total Claims

219K

Providers

572

Avg Cost/Claim

$127

National Cost Distribution

How much do providers bill per claim for 99235? Based on 556 providers billing this code nationally.

Median

$110.13

Average

$118.20

Std Dev

$111.71

Max

$1,830.51

Percentile Distribution (Cost per Claim)

p10
$56.03
p25
$85.75
Median
$110.13
p75
$127.97
p90
$151.46
p95
$191.53
p99
$460.93

50% of providers bill between $85.75 and $127.97 per claim for this code.

90% bill between $56.03 and $151.46.

Top 1% bill above $460.93.

About This Procedure

HCPCS code 99235 was billed by 572 providers across 219K claims, totaling $27.8M in Medicaid payments from 2018–2024. This code was used for 177K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$110.13

Providers Billing

556

National Spending

$27.8M

Avg/Median Ratio

1.07×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99235

#ProviderTotal Paid
1Temple University Hospital Inc

Philadelphia, PA · General Acute Care Hospital

$2.7M
21306940481$1.5M
31295270254$1.2M
41043260474$664K
51346373156$648K
61306882261$548K
7The Nemours Foundation

Wilmington, DE · Clinic/Center, Developmental Disabilities

$457K
81790976199$427K
9Albert Einstein Medical Center

Phila, PA · General Acute Care Hospital

$405K
101699212175$334K
111154355931$324K
121588651426$320K
131720569973$318K
141386160265$313K
15Trustees Of The University Of Pennsylvania

Philadelphia, PA · Community/Behavioral Health

$311K
161346759768$303K
171760133201$303K
181679188189$302K
191972039790$294K
201700999471$280K

Showing top 20 of 572 providers billing this code