Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1855 of 11K

99304

HCPCS Procedure Code

HCPCS code 99304 is the #1,855 most-billed Medicaid procedure code, with $12.7M in payments across 440K claims from 2018–2024. The national median cost per claim is $13.51. Costs vary widely — the 90th percentile is $43.56 per claim, 3.2× the median.

Total Paid

$12.7M

0.00% of all spending

Total Claims

440K

Providers

1,560

Avg Cost/Claim

$29

National Cost Distribution

How much do providers bill per claim for 99304? Based on 1,429 providers billing this code nationally.

Median

$13.51

Average

$27.72

Std Dev

$53.50

Max

$415.69

Percentile Distribution (Cost per Claim)

p10
$3.23
p25
$7.03
Median
$13.51
p75
$25.36
p90
$43.56
p95
$83.52
p99
$300.61

50% of providers bill between $7.03 and $25.36 per claim for this code.

90% bill between $3.23 and $43.56.

Top 1% bill above $300.61.

About This Procedure

HCPCS code 99304 was billed by 1,560 providers across 440K claims, totaling $12.7M in Medicaid payments from 2018–2024. This code was used for 388K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.51

Providers Billing

1,429

National Spending

$12.7M

Avg/Median Ratio

2.05×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 99304

#ProviderTotal Paid
11578709515$865K
21417152570$826K
31811049026$389K
41184167991$308K
51487790937$299K
61679542658$244K
71871594614$242K
81083883938$234K
91003113705$226K
101659610814$223K
111639178809$195K
121962951715$191K
131841275344$188K
141487654042$185K
151104825520$183K
161083962294$168K
171649222506$159K
181588122535$156K
191801193768$153K
201114393311$148K

Showing top 20 of 1,560 providers billing this code