#4134 of 11K

99465

HCPCS Procedure Code

HCPCS code 99465 is the #4,134 most-billed Medicaid procedure code, with $818K in payments across 8,514 claims from 2018–2024. The national median cost per claim is $99.16.

Total Paid

$818K

0.00% of all spending

Total Claims

8,514

Providers

Avg Cost/Claim

$96

National Cost Distribution

How much do providers bill per claim for 99465? Based on 54 providers billing this code nationally.

Median

$99.16

Average

$112.63

Std Dev

$36.23

Max

$181.17

Percentile Distribution (Cost per Claim)

p10

$76.71

p25

$82.47

Median

$99.16

p75

$143.82

p90

$160.23

p95

$171.52

p99

$179.89

50% of providers bill between $82.47 and $143.82 per claim for this code.

90% bill between $76.71 and $160.23.

Top 1% bill above $179.89.

About This Procedure

HCPCS code 99465 was billed by 57 providers across 8,514 claims, totaling $818K in Medicaid payments from 2018–2024. This code was used for 8,148 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$99.16

Providers Billing

National Spending

$818K

Avg/Median Ratio

1.14×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99465

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1760441844	$155K	$170.52	1.7× median	Top 10%
2	1720185432	$147K	$82.42	0.8× median	Below Median
3	Neo Natal Associates Plc Grand Rapids, MI · Pediatrics Neonatal-Perinatal Medicine	$123K	$81.10	0.8× median	Below Median
4	1912965088	$49K	$81.40	0.8× median	Below Median
5	William Beaumont Hospital Royal Oak, MI · Internal Medicine, Cardiovascular Disease	$46K	$81.53	0.8× median	Below Median
6	1104900455	$43K	$84.08	0.8× median	Below Median
7	1184960924	$27K	$88.18	0.9× median	Below Median
8	1841365921	$25K	$131.68	1.3× median	Above Median
9	1619469343	$22K	$93.48	0.9× median	Below Median
10	1518991413	$20K	$81.10	0.8× median	Below Median
11	1205928587	$15K	$95.41	1.0× median	Below Median
12	1811920549	$15K	$84.52	0.9× median	Below Median
13	1003829441	$13K	$82.63	0.8× median	Below Median
14	1265726707	$10K	$157.42	1.6× median	Above 75th
15	1427031541	$9K	$65.74	0.7× median	Below Median
16	1457396541	$9K	$150.58	1.5× median	Above 75th
17	1063964708	$7K	$130.78	1.3× median	Above Median
18	1073742185	$6K	$139.96	1.4× median	Above Median
19	1003990318	$5K	$83.66	0.8× median	Below Median
20	1376782060	$4K	$100.01	1.0× median	Above Median

Showing top 20 of 57 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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