99454
HCPCS Procedure Code
HCPCS code 99454 is the #1,703 most-billed Medicaid procedure code, with $15.8M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $9.15. Costs vary widely — the 90th percentile is $34.43 per claim, 3.8× the median.
Total Paid
$15.8M
0.00% of all spending
Total Claims
1.1M
Providers
2K
Avg Cost/Claim
$14
National Cost Distribution
How much do providers bill per claim for 99454? Based on 1K providers billing this code nationally.
Median
$9.15
Average
$14.09
Std Dev
$15.94
Max
$150.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.44 and $18.55 per claim for this code.
90% bill between $1.17 and $34.43.
Top 1% bill above $67.22.
About This Procedure
HCPCS code 99454 was billed by 2K providers across 1.1M claims, totaling $15.8M in Medicaid payments from 2018–2024. This code was used for 1.0M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$9.15
Providers Billing
1K
National Spending
$15.8M
Avg/Median Ratio
1.54×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 99454
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1538564463 | $995K |
| 2 | 1811544174 | $477K |
| 3 | 1063965093 | $472K |
| 4 | 1902957970 | $316K |
| 5 | 1750613329 | $240K |
| 6 | 1285223552 | $226K |
| 7 | 1609188796 | $225K |
| 8 | 1356960058 | $224K |
| 9 | Bronxcare Health System Bronx, NY · General Acute Care Hospital | $220K |
| 10 | 1629520986 | $209K |
| 11 | 1760594451 | $190K |
| 12 | 1477151660 | $180K |
| 13 | 1306371257 | $168K |
| 14 | 1992007819 | $165K |
| 15 | 1104096015 | $159K |
| 16 | 1437622057 | $147K |
| 17 | 1083925168 | $140K |
| 18 | 1508086109 | $131K |
| 19 | 1689799579 | $129K |
| 20 | 1992215446 | $127K |
Showing top 20 of 2K providers billing this code