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#140 of 11K

99291

Critical care, first 30-74 minutes

Critical care, first 30-74 minutes is the #140 most-billed Medicaid procedure code, with $1.31B in payments across 10.9M claims from 2018–2024. The national median cost per claim is $101.24.

Total Paid

$1.31B

0.12% of all spending

Total Claims

10.9M

Providers

8K

Avg Cost/Claim

$120

National Cost Distribution

How much do providers bill per claim for 99291? Based on 8K providers billing this code nationally.

Median

$101.24

Average

$124.94

Std Dev

$136.79

Max

$2,887.79

Percentile Distribution (Cost per Claim)

p10
$38.87
p25
$64.21
Median
$101.24
p75
$136.27
p90
$195.87
p95
$296.65
p99
$774.50

50% of providers bill between $64.21 and $136.27 per claim for this code.

90% bill between $38.87 and $195.87.

Top 1% bill above $774.50.

About This Procedure

HCPCS code 99291 (Critical care, first 30-74 minutes) was billed by 8K providers across 10.9M claims, totaling $1.31B in Medicaid payments from 2018–2024. This code was used for 5.8M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$101.24

Providers Billing

8K

National Spending

$1.31B

Avg/Median Ratio

1.23×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99291

#ProviderTotal Paid
1Hennepin Healthcare System Inc

Minneapolis, MN · General Acute Care Hospital

$13.5M
21124374822$8.6M
31952792475$8.0M
41386813103$7.3M
5Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$6.7M
6Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$6.6M
7Mep Health Llc

Rockville, MD · Emergency Medicine

$5.8M
8Bridgeport Hospital

Bridgeport, CT · General Acute Care Hospital

$5.7M
9Banner Thunderbird Medical Center

Glendale, AZ · Community/Behavioral Health

$5.7M
101417285230$5.7M
11Ut Physicians

Houston, TX · Emergency Medicine

$5.6M
121962712828$5.4M
131700154226$5.4M
14Banner-university Medical Group

Phoenix, AZ · Clinic/Center, Primary Care

$5.2M
15University Physicians Incorporated

Aurora, CO · Anesthesiology

$5.1M
161750751566$5.1M
171831296995$5.0M
181952533887$5.0M
191033135520$5.0M
201831218627$4.9M

Showing top 20 of 8K providers billing this code