#2927 of 11K

99463

HCPCS Procedure Code

HCPCS code 99463 is the #2,927 most-billed Medicaid procedure code, with $3.0M in payments across 36K claims from 2018–2024. The national median cost per claim is $78.46.

Total Paid

$3.0M

0.00% of all spending

Total Claims

36K

Providers

195

Avg Cost/Claim

$84

National Cost Distribution

How much do providers bill per claim for 99463? Based on 193 providers billing this code nationally.

Median

$78.46

Average

$79.93

Std Dev

$26.14

Max

$180.58

Percentile Distribution (Cost per Claim)

p10

$50.56

p25

$63.83

Median

$78.46

p75

$100.15

p90

$108.65

p95

$114.90

p99

$135.62

50% of providers bill between $63.83 and $100.15 per claim for this code.

90% bill between $50.56 and $108.65.

Top 1% bill above $135.62.

About This Procedure

HCPCS code 99463 was billed by 195 providers across 36K claims, totaling $3.0M in Medicaid payments from 2018–2024. This code was used for 35K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$78.46

Providers Billing

193

National Spending

$3.0M

Avg/Median Ratio

1.02×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99463

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1649377359	$316K	$106.67	1.4× median	Above 75th
2	1801856786	$230K	$111.93	1.4× median	Top 10%
3	1902941503	$176K	$103.42	1.3× median	Above 75th
4	1144327859	$166K	$100.15	1.3× median	Above Median
5	1841573870	$115K	$86.10	1.1× median	Above Median
6	1720185432	$80K	$63.29	0.8× median	Below Median
7	1013988146	$80K	$80.96	1.0× median	Above Median
8	1447789250	$80K	$109.53	1.4× median	Top 10%
9	1487824223	$69K	$100.96	1.3× median	Above 75th
10	1194892612	$65K	$62.41	0.8× median	Below Median
11	1700072964	$62K	$105.70	1.3× median	Above 75th
12	1144630682	$57K	$109.88	1.4× median	Top 10%
13	1770997033	$54K	$109.62	1.4× median	Top 10%
14	1003829441	$51K	$63.83	0.8× median	Below Median
15	1326208398	$48K	$84.49	1.1× median	Above Median
16	1477742807	$47K	$74.86	1.0× median	Below Median
17	1194099390	$44K	$99.22	1.3× median	Above Median
18	1972695260	$43K	$93.75	1.2× median	Above Median
19	William Beaumont Hospital Royal Oak, MI · Internal Medicine, Cardiovascular Disease	$42K	$62.80	0.8× median	Below Median
20	1497852107	$41K	$61.99	0.8× median	Below Median

Showing top 20 of 195 providers billing this code

Related Procedures

99469Subsequent intensive care, very low birth weight infant$613.0M 99472Subsequent pediatric critical care, per day, age 2-5$432.6M 99460Initial hospital or birthing center care, newborn, per day$239.9M 99468$61.2M 99462$56.2M

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