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#3133 of 11K

99316

HCPCS Procedure Code

HCPCS code 99316 is the #3,133 most-billed Medicaid procedure code, with $2.4M in payments across 66K claims from 2018–2024. The national median cost per claim is $25.78. Costs vary widely — the 90th percentile is $57.23 per claim, 2.2× the median.

Total Paid

$2.4M

0.00% of all spending

Total Claims

66K

Providers

367

Avg Cost/Claim

$36

National Cost Distribution

How much do providers bill per claim for 99316? Based on 347 providers billing this code nationally.

Median

$25.78

Average

$30.42

Std Dev

$22.53

Max

$159.62

Percentile Distribution (Cost per Claim)

p10
$7.16
p25
$14.00
Median
$25.78
p75
$41.83
p90
$57.23
p95
$71.05
p99
$100.38

50% of providers bill between $14.00 and $41.83 per claim for this code.

90% bill between $7.16 and $57.23.

Top 1% bill above $100.38.

About This Procedure

HCPCS code 99316 was billed by 367 providers across 66K claims, totaling $2.4M in Medicaid payments from 2018–2024. This code was used for 61K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$25.78

Providers Billing

347

National Spending

$2.4M

Avg/Median Ratio

1.18×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99316

#ProviderTotal Paid
11881109452$183K
21609362375$142K
31942267901$118K
4Reliant Physicians (Kumar) Pllc

Las Vegas, NV · Hospitalist

$115K
5Maryland Medical First P.a.

Baltimore, MD · Internal Medicine

$77K
61215129853$72K
71124313309$71K
81710385554$69K
91275576522$62K
101538355144$60K
111558318345$54K
121669901567$47K
131013466192$45K
141093254419$43K
151427246453$42K
16Group Health Plan, Inc.

Minneapolis, MN · Clinic/Center, Multi-Specialty

$40K
171801325634$38K
181912105297$37K
191194360784$37K
201598297871$35K

Showing top 20 of 367 providers billing this code