99284
Emergency dept visit, high complexity
Emergency dept visit, high complexity is the #7 most-billed Medicaid procedure code, with $20.15B in payments across 170.7M claims from 2018–2024. The national median cost per claim is $69.51. Costs vary widely — the 90th percentile is $166.96 per claim, 2.4× the median.
Total Paid
$20.15B
1.84% of all spending
Total Claims
170.7M
Providers
21K
Avg Cost/Claim
$118
National Cost Distribution
How much do providers bill per claim for 99284? Based on 21K providers billing this code nationally.
Median
$69.51
Average
$91.17
Std Dev
$90.28
Max
$1,834.24
Percentile Distribution (Cost per Claim)
50% of providers bill between $51.07 and $93.87 per claim for this code.
90% bill between $35.99 and $166.96.
Top 1% bill above $465.29.
About This Procedure
HCPCS code 99284 (Emergency dept visit, high complexity) was billed by 21K providers across 170.7M claims, totaling $20.15B in Medicaid payments from 2018–2024. This code was used for 154.9M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$69.51
Providers Billing
21K
National Spending
$20.15B
Avg/Median Ratio
1.31×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 99284
| # | Provider | Total Paid |
|---|---|---|
| 1 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $95.2M |
| 2 | Southeastern Emergency Physicians Llc Maysville, KY · Emergency Medicine, Pediatric Emergency Medicine | $84.5M |
| 3 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $82.4M |
| 4 | Virtua - West Jersey Health System Inc. Voorhees, NJ · General Acute Care Hospital | $74.9M |
| 5 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $71.0M |
| 6 | Cook Children's Medical Center Fort Worth, TX · General Acute Care Hospital Children | $70.1M |
| 7 | Kennedy University Hospital Inc. Stratford, NJ · General Acute Care Hospital | $67.5M |
| 8 | Wakemed Raleigh, NC · General Acute Care Hospital | $65.6M |
| 9 | Mcallen Hospitals L P Edinburg, TX · General Acute Care Hospital | $62.9M |
| 10 | St Josephs University Medical Center Inc. Paterson, NJ · General Acute Care Hospital | $59.3M |
| 11 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $56.4M |
| 12 | Antelope Valley Health Care District Lancaster, CA · General Acute Care Hospital | $55.2M |
| 13 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $53.8M |
| 14 | Bridgeport Hospital Bridgeport, CT · General Acute Care Hospital | $53.6M |
| 15 | Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital | $53.3M |
| 16 | Texas Children's Hospital Houston, TX · General Acute Care Hospital Children | $52.7M |
| 17 | Rwjbh Emergency Medicine Associates, Llc Somerset, NJ · Nurse Practitioner, Primary Care | $52.2M |
| 18 | Inspira Medical Centers Inc. Vineland, NJ · General Acute Care Hospital | $51.6M |
| 19 | North Shore-lij Medical Pc Great Neck, NY · Urology | $51.0M |
| 20 | Ochsner Clinic Foundation New Orleans, LA · General Acute Care Hospital | $48.4M |
Showing top 20 of 21K providers billing this code