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#1865 of 11K

99403

HCPCS Procedure Code

HCPCS code 99403 is the #1,865 most-billed Medicaid procedure code, with $12.5M in payments across 381K claims from 2018–2024. The national median cost per claim is $47.11. Costs vary widely — the 90th percentile is $130.93 per claim, 2.8× the median.

Total Paid

$12.5M

0.00% of all spending

Total Claims

381K

Providers

352

Avg Cost/Claim

$33

National Cost Distribution

How much do providers bill per claim for 99403? Based on 300 providers billing this code nationally.

Median

$47.11

Average

$57.72

Std Dev

$48.61

Max

$334.43

Percentile Distribution (Cost per Claim)

p10
$3.61
p25
$25.71
Median
$47.11
p75
$77.06
p90
$130.93
p95
$143.97
p99
$183.92

50% of providers bill between $25.71 and $77.06 per claim for this code.

90% bill between $3.61 and $130.93.

Top 1% bill above $183.92.

About This Procedure

HCPCS code 99403 was billed by 352 providers across 381K claims, totaling $12.5M in Medicaid payments from 2018–2024. This code was used for 165K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$47.11

Providers Billing

300

National Spending

$12.5M

Avg/Median Ratio

1.23×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99403

#ProviderTotal Paid
11720171895$2.7M
21609849660$703K
31376502088$696K
41821597444$549K
51487619714$476K
61386751907$422K
71083687719$404K
81780603399$308K
91174612592$293K
101841268216$290K
111285600213$246K
121376675470$213K
131528034170$197K
141932177409$172K
151083126155$157K
161659934982$152K
171104391598$152K
181902855026$150K
191518093491$147K
201568428837$140K

Showing top 20 of 352 providers billing this code