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#9 of 11K

99283

Emergency dept visit, moderate complexity

Emergency dept visit, moderate complexity is the #9 most-billed Medicaid procedure code, with $16.87B in payments across 157.9M claims from 2018–2024. The national median cost per claim is $42.48. Costs vary widely — the 90th percentile is $140.72 per claim, 3.3× the median.

Total Paid

$16.87B

1.54% of all spending

Total Claims

157.9M

Providers

20K

Avg Cost/Claim

$107

National Cost Distribution

How much do providers bill per claim for 99283? Based on 20K providers billing this code nationally.

Median

$42.48

Average

$66.01

Std Dev

$74.85

Max

$1,135.20

Percentile Distribution (Cost per Claim)

p10
$25.80
p25
$33.78
Median
$42.48
p75
$62.00
p90
$140.72
p95
$182.95
p99
$365.61

50% of providers bill between $33.78 and $62.00 per claim for this code.

90% bill between $25.80 and $140.72.

Top 1% bill above $365.61.

About This Procedure

HCPCS code 99283 (Emergency dept visit, moderate complexity) was billed by 20K providers across 157.9M claims, totaling $16.87B in Medicaid payments from 2018–2024. This code was used for 144.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$42.48

Providers Billing

20K

National Spending

$16.87B

Avg/Median Ratio

1.55×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 99283

#ProviderTotal Paid
1Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$63.2M
2Loma Linda University Children's Hospital

Loma Linda, CA · General Acute Care Hospital Children

$57.6M
3Newark Beth Israel Medical Center Inc

Newark, NJ · General Acute Care Hospital

$56.3M
4Childrens Hospital Of Philadelphia

Philadelphia, PA · General Acute Care Hospital Children

$54.8M
5Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$53.9M
6St Josephs University Medical Center Inc.

Paterson, NJ · General Acute Care Hospital

$53.8M
7Children's Health System Of Texas

Dallas, TX · General Acute Care Hospital Children

$53.6M
8Children's Hospital

New Orleans, LA · General Acute Care Hospital Children

$51.3M
9Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$50.6M
10Atlanticare Regional Medical Center

Pomona, NJ · General Acute Care Hospital

$48.5M
11Cook Children's Medical Center

Fort Worth, TX · General Acute Care Hospital Children

$46.5M
12Virtua - West Jersey Health System Inc.

Voorhees, NJ · General Acute Care Hospital

$46.2M
13Our Lady Of The Lake Hospital Inc.

Baton Rouge, LA · General Acute Care Hospital

$45.9M
14Maricopa County Special Health Care District

Phoenix, AZ · General Acute Care Hospital

$45.6M
15Bakersfield Memorial Hospital

Bakersfield, CA · General Acute Care Hospital

$45.5M
16University Hospital

Newark, NJ · General Acute Care Hospital

$42.8M
171043263080$42.2M
18Children's Hospital

Washington, DC · General Acute Care Hospital Children

$41.1M
19Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$40.5M
20Inspira Medical Centers Inc.

Vineland, NJ · General Acute Care Hospital

$39.9M

Showing top 20 of 20K providers billing this code