#2761 of 11K

99476

HCPCS Procedure Code

HCPCS code 99476 is the #2,761 most-billed Medicaid procedure code, with $3.8M in payments across 13K claims from 2018–2024. The national median cost per claim is $290.39.

Total Paid

$3.8M

0.00% of all spending

Total Claims

13K

Providers

Avg Cost/Claim

$297

National Cost Distribution

How much do providers bill per claim for 99476? Based on 39 providers billing this code nationally.

Median

$290.39

Average

$324.96

Std Dev

$196.06

Max

$1,383.62

Percentile Distribution (Cost per Claim)

p10

$203.28

p25

$240.59

Median

$290.39

p75

$323.42

p90

$439.64

p95

$548.98

p99

$1,076.74

50% of providers bill between $240.59 and $323.42 per claim for this code.

90% bill between $203.28 and $439.64.

Top 1% bill above $1,076.74.

About This Procedure

HCPCS code 99476 was billed by 39 providers across 13K claims, totaling $3.8M in Medicaid payments from 2018–2024. This code was used for 3,350 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$290.39

Providers Billing

National Spending

$3.8M

Avg/Median Ratio

1.12×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99476

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1811920549	$1.3M	$293.96	1.0× median	Above Median
2	Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent	$578K	$268.36	0.9× median	Below Median
3	1669454617	$358K	$294.00	1.0× median	Above Median
4	1801869250	$266K	$545.97	1.9× median	Top 10%
5	1629001169	$197K	$290.39	1.0× median	Below Median
6	1497850291	$107K	$346.96	1.2× median	Above 75th
7	1336482256	$104K	$185.92	0.6× median	Below Median
8	The Nemours Foundation Wilmington, DE · Clinic/Center, Developmental Disabilities	$98K	$510.88	1.8× median	Top 10%
9	1891156741	$90K	$237.93	0.8× median	Below Median
10	1023237518	$76K	$249.31	0.9× median	Below Median
11	1780800128	$73K	$309.34	1.1× median	Above Median
12	Ou Health Partners, Inc Oklahoma City, OK · Clinic/Center, Multi-Specialty	$63K	$576.04	2.0× median	Top 10%
13	1477537892	$40K	$1,383.62	4.8× median	Top 1%
14	1750351375	$28K	$263.67	0.9× median	Below Median
15	Cook Children's Physician Network Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.)	$26K	$265.19	0.9× median	Below Median
16	Saint Peter's University Hospital New Brunswick, NJ · General Acute Care Hospital	$25K	$270.60	0.9× median	Below Median
17	West Virginia University Medical Corporation Morgantown, WV · Anesthesiology	$25K	$218.53	0.8× median	Below Median
18	Texas Children's Physician Group Houston, TX · Pediatrics	$24K	$312.55	1.1× median	Above Median
19	1093024101	$22K	$319.78	1.1× median	Above Median
20	1831218627	$22K	$327.06	1.1× median	Above 75th

Showing top 20 of 39 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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