#5030 of 11K

99427

HCPCS Procedure Code

HCPCS code 99427 is the #5,030 most-billed Medicaid procedure code, with $316K in payments across 28K claims from 2018–2024. The national median cost per claim is $9.64. Costs vary widely — the 90th percentile is $47.78 per claim, 5.0× the median.

Total Paid

$316K

0.00% of all spending

Total Claims

28K

Providers

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for 99427? Based on 43 providers billing this code nationally.

Median

$9.64

Average

$18.43

Std Dev

$19.54

Max

$70.65

Percentile Distribution (Cost per Claim)

p10

$0.80

p25

$2.66

Median

$9.64

p75

$31.49

p90

$47.78

p95

$56.43

p99

$65.84

50% of providers bill between $2.66 and $31.49 per claim for this code.

90% bill between $0.80 and $47.78.

Top 1% bill above $65.84.

About This Procedure

HCPCS code 99427 was billed by 52 providers across 28K claims, totaling $316K in Medicaid payments from 2018–2024. This code was used for 27K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.64

Providers Billing

National Spending

$316K

Avg/Median Ratio

1.91×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 99427

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1033803143	$63K	$56.58	5.9× median	Top 10%
2	1275257479	$50K	$48.87	5.1× median	Top 10%
3	1295435873	$31K	$39.74	4.1× median	Above 75th
4	1457735805	$22K	$26.56	2.8× median	Above Median
5	1942866462	$22K	$59.20	6.1× median	Top 10%
6	1922440684	$20K	$13.60	1.4× median	Above Median
7	1023781028	$18K	$22.72	2.4× median	Above Median
8	1417143488	$13K	$13.77	1.4× median	Above Median
9	1770253452	$12K	$43.41	4.5× median	Above 75th
10	1750331013	$11K	$32.22	3.3× median	Above 75th
11	1073833984	$10K	$32.94	3.4× median	Above 75th
12	1407483175	$10K	$2.72	0.3× median	Below Median
13	1467493049	$8K	$19.07	2.0× median	Above Median
14	Mainegeneral Medical Center Augusta, ME · General Acute Care Hospital	$7K	$39.61	4.1× median	Above 75th
15	1265723548	$3K	$20.82	2.2× median	Above Median
16	1609338870	$2K	$24.77	2.6× median	Above Median
17	1134507189	$2K	$39.73	4.1× median	Above 75th
18	Chinatown True Care Medical Pllc New York, NY · Family Medicine	$2K	$70.65	7.3× median	Top 1%
19	1841076031	$2K	$30.77	3.2× median	Above Median
20	1700558798	$2K	$0.64	0.1× median	Below Median

Showing top 20 of 52 providers billing this code

Related Procedures

99417$33.2M 99429$32.9M 99423Online digital E/M, 21+ min$13.6M 99421Online digital E/M, 5-10 min$6.2M 99422Online digital E/M, 11-20 min$4.2M

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