#6973 of 11K

99473

HCPCS Procedure Code

HCPCS code 99473 is the #6,973 most-billed Medicaid procedure code, with $34K in payments across 19K claims from 2018–2024. The national median cost per claim is $2.27. Costs vary widely — the 90th percentile is $7.33 per claim, 3.2× the median.

Total Paid

$34K

0.00% of all spending

Total Claims

19K

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 99473? Based on 41 providers billing this code nationally.

Median

$2.27

Average

$3.33

Std Dev

$2.92

Max

$13.73

Percentile Distribution (Cost per Claim)

p10

$0.53

p25

$1.49

Median

$2.27

p75

$4.11

p90

$7.33

p95

$7.97

p99

$12.08

50% of providers bill between $1.49 and $4.11 per claim for this code.

90% bill between $0.53 and $7.33.

Top 1% bill above $12.08.

About This Procedure

HCPCS code 99473 was billed by 53 providers across 19K claims, totaling $34K in Medicaid payments from 2018–2024. This code was used for 17K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$2.27

Providers Billing

National Spending

$34K

Avg/Median Ratio

1.47×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99473

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1336505197	$9K	$2.27	1.0× median	Below Median
2	1487169660	$7K	$1.52	0.7× median	Below Median
3	1811430523	$5K	$2.63	1.2× median	Above Median
4	1063920296	$2K	$13.73	6.0× median	Top 1%
5	1437796216	$1K	$6.38	2.8× median	Above 75th
6	1710592126	$1K	$2.89	1.3× median	Above Median
7	1366871378	$1K	$2.56	1.1× median	Above Median
8	1700523362	$855	$2.57	1.1× median	Above Median
9	1457084386	$832	$1.32	0.6× median	Below Median
10	1760646095	$690	$6.45	2.8× median	Above 75th
11	1205248796	$602	$4.07	1.8× median	Above Median
12	1790421253	$585	$7.91	3.5× median	Top 10%
13	1306983812	$499	$7.33	3.2× median	Top 10%
14	1184199275	$459	$0.91	0.4× median	Below Median
15	1952406290	$450	$0.52	0.2× median	Below Median
16	1053930248	$310	$1.94	0.9× median	Below Median
17	1194364984	$275	$5.86	2.6× median	Above 75th
18	1275785461	$269	$9.60	4.2× median	Top 10%
19	1679121958	$267	$1.86	0.8× median	Below Median
20	1568858637	$228	$4.00	1.8× median	Above Median

Showing top 20 of 53 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 99479Subsequent intensive care, 2,501-5,000 grams$354.9M 99480Subsequent intensive care, very low birth weight infant$273.2M 99468$61.2M

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