#4543 of 11K

99453

HCPCS Procedure Code

HCPCS code 99453 is the #4,543 most-billed Medicaid procedure code, with $524K in payments across 88K claims from 2018–2024. The national median cost per claim is $3.83. Costs vary widely — the 90th percentile is $14.48 per claim, 3.8× the median.

Total Paid

$524K

0.00% of all spending

Total Claims

88K

Providers

743

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 99453? Based on 594 providers billing this code nationally.

Median

$3.83

Average

$6.39

Std Dev

$8.08

Max

$84.41

Percentile Distribution (Cost per Claim)

p10

$0.58

p25

$1.51

Median

$3.83

p75

$9.50

p90

$14.48

p95

$17.77

p99

$31.71

50% of providers bill between $1.51 and $9.50 per claim for this code.

90% bill between $0.58 and $14.48.

Top 1% bill above $31.71.

About This Procedure

HCPCS code 99453 was billed by 743 providers across 88K claims, totaling $524K in Medicaid payments from 2018–2024. This code was used for 79K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3.83

Providers Billing

594

National Spending

$524K

Avg/Median Ratio

1.67×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 99453

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Bronxcare Health System Bronx, NY · General Acute Care Hospital	$45K	$59.92	15.6× median	Top 1%
2	Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital	$37K	$78.66	20.5× median	Top 1%
3	1811544174	$28K	$16.43	4.3× median	Top 10%
4	1538564463	$27K	$14.87	3.9× median	Top 10%
5	1750613329	$17K	$17.95	4.7× median	Top 10%
6	1144209271	$16K	$84.41	22.0× median	Top 1%
7	1760626477	$15K	$15.84	4.1× median	Top 10%
8	1902271661	$12K	$8.00	2.1× median	Above Median
9	1811226749	$9K	$11.12	2.9× median	Above 75th
10	1356960058	$8K	$8.47	2.2× median	Above Median
11	1881861953	$8K	$13.29	3.5× median	Above 75th
12	1477151660	$8K	$5.61	1.5× median	Above Median
13	1992215446	$7K	$0.66	0.2× median	Below Median
14	1083925168	$6K	$10.39	2.7× median	Above 75th
15	1548538200	$6K	$5.03	1.3× median	Above Median
16	1508493156	$5K	$20.15	5.3× median	Top 10%
17	1972250694	$5K	$4.63	1.2× median	Above Median
18	1194315564	$5K	$2.73	0.7× median	Below Median
19	1073889069	$5K	$47.27	12.3× median	Top 1%
20	1518930270	$4K	$20.12	5.3× median	Top 10%

Showing top 20 of 743 providers billing this code

Related Procedures

99460Initial hospital or birthing center care, newborn, per day$239.9M 99443Telephone E/M by physician, 21-30 min$145.6M 99462$56.2M 99456$30.3M 99444$27.6M

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