#1538 of 11K

99292

HCPCS Procedure Code

HCPCS code 99292 is the #1,538 most-billed Medicaid procedure code, with $19.8M in payments across 273K claims from 2018–2024. The national median cost per claim is $57.64. Costs vary widely — the 90th percentile is $121.39 per claim, 2.1× the median.

Total Paid

$19.8M

0.00% of all spending

Total Claims

273K

Providers

650

Avg Cost/Claim

$73

National Cost Distribution

How much do providers bill per claim for 99292? Based on 623 providers billing this code nationally.

Median

$57.64

Average

$69.78

Std Dev

$69.94

Max

$834.56

Percentile Distribution (Cost per Claim)

p10

$17.73

p25

$36.11

Median

$57.64

p75

$84.88

p90

$121.39

p95

$148.54

p99

$294.12

50% of providers bill between $36.11 and $84.88 per claim for this code.

90% bill between $17.73 and $121.39.

Top 1% bill above $294.12.

About This Procedure

HCPCS code 99292 was billed by 650 providers across 273K claims, totaling $19.8M in Medicaid payments from 2018–2024. This code was used for 152K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$57.64

Providers Billing

623

National Spending

$19.8M

Avg/Median Ratio

1.21×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99292

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1386813103	$1.9M	$101.50	1.8× median	Above 75th
2	1477537892	$1.3M	$339.70	5.9× median	Top 1%
3	1649561580	$1.0M	$61.42	1.1× median	Above Median
4	1578671137	$676K	$90.20	1.6× median	Above 75th
5	Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent	$637K	$80.00	1.4× median	Above Median
6	1609853688	$628K	$132.77	2.3× median	Top 10%
7	1811920549	$607K	$114.97	2.0× median	Above 75th
8	1306354626	$570K	$58.17	1.0× median	Above Median
9	1154819126	$434K	$109.61	1.9× median	Above 75th
10	1770192437	$333K	$63.34	1.1× median	Above Median
11	The Nemours Foundation Wilmington, DE · Clinic/Center, Developmental Disabilities	$265K	$168.31	2.9× median	Top 10%
12	1225083595	$260K	$73.33	1.3× median	Above Median
13	Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital	$255K	$104.07	1.8× median	Above 75th
14	Not Found Unknown, Unknown · Unknown	$253K	$131.51	2.3× median	Top 10%
15	1972912228	$247K	$88.00	1.5× median	Above 75th
16	1285079764	$223K	$130.66	2.3× median	Top 10%
17	1639517436	$215K	$73.70	1.3× median	Above Median
18	West Virginia University Medical Corporation Morgantown, WV · Anesthesiology	$204K	$81.83	1.4× median	Above Median
19	Montefiore Medical Center Bronx, NY · Anesthesiology	$199K	$132.98	2.3× median	Top 10%
20	1104875970	$197K	$48.71	0.8× median	Below Median

Showing top 20 of 650 providers billing this code

Related Procedures

99284Emergency dept visit, high complexity$20.15B 99283Emergency dept visit, moderate complexity$16.87B 99285Emergency dept visit, high/urgent complexity$15.10B 99282Emergency dept visit, low complexity$2.53B 99291Critical care, first 30-74 minutes$1.31B

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