#1804 of 11K

99423

Online digital E/M, 21+ min

Online digital E/M, 21+ min is the #1,804 most-billed Medicaid procedure code, with $13.6M in payments across 322K claims from 2018–2024. The national median cost per claim is $38.12.

Total Paid

$13.6M

0.00% of all spending

Total Claims

322K

Providers

452

Avg Cost/Claim

$42

National Cost Distribution

How much do providers bill per claim for 99423? Based on 398 providers billing this code nationally.

Median

$38.12

Average

$47.91

Std Dev

$98.16

Max

$938.16

Percentile Distribution (Cost per Claim)

p10

$4.21

p25

$15.20

Median

$38.12

p75

$54.39

p90

$57.17

p95

$64.92

p99

$725.26

50% of providers bill between $15.20 and $54.39 per claim for this code.

90% bill between $4.21 and $57.17.

Top 1% bill above $725.26.

About This Procedure

HCPCS code 99423 (Online digital E/M, 21+ min) was billed by 452 providers across 322K claims, totaling $13.6M in Medicaid payments from 2018–2024. This code was used for 117K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$38.12

Providers Billing

398

National Spending

$13.6M

Avg/Median Ratio

1.26×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99423

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1962692574	$1.2M	$29.91	0.8× median	Below Median
2	1841469277	$709K	$56.96	1.5× median	Above 75th
3	1275864928	$595K	$55.70	1.5× median	Above 75th
4	1558572511	$396K	$56.68	1.5× median	Above 75th
5	1366745317	$364K	$33.38	0.9× median	Below Median
6	1770814170	$325K	$56.58	1.5× median	Above 75th
7	1891823217	$299K	$57.16	1.5× median	Above 75th
8	1356738488	$298K	$52.31	1.4× median	Above Median
9	1023337839	$269K	$56.87	1.5× median	Above 75th
10	1083664759	$219K	$55.32	1.5× median	Above 75th
11	1093990079	$206K	$55.72	1.5× median	Above 75th
12	1336547140	$194K	$56.00	1.5× median	Above 75th
13	1821387382	$189K	$39.59	1.0× median	Above Median
14	1104278860	$179K	$56.29	1.5× median	Above 75th
15	1609113745	$178K	$56.02	1.5× median	Above 75th
16	1558391730	$173K	$55.20	1.4× median	Above 75th
17	1043307986	$166K	$54.79	1.4× median	Above 75th
18	1952328866	$158K	$57.14	1.5× median	Above 75th
19	1144358391	$152K	$26.70	0.7× median	Below Median
20	1093062937	$144K	$50.95	1.3× median	Above Median

Showing top 20 of 452 providers billing this code

Related Procedures

99417$33.2M 99429$32.9M 99421Online digital E/M, 5-10 min$6.2M 99422Online digital E/M, 11-20 min$4.2M 99424$1.8M

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