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#3086 of 11K

99478

HCPCS Procedure Code

HCPCS code 99478 is the #3,086 most-billed Medicaid procedure code, with $2.5M in payments across 22K claims from 2018–2024. The national median cost per claim is $106.11.

Total Paid

$2.5M

0.00% of all spending

Total Claims

22K

Providers

55

Avg Cost/Claim

$117

National Cost Distribution

How much do providers bill per claim for 99478? Based on 55 providers billing this code nationally.

Median

$106.11

Average

$108.80

Std Dev

$36.92

Max

$218.91

Percentile Distribution (Cost per Claim)

p10
$75.98
p25
$86.38
Median
$106.11
p75
$126.39
p90
$150.73
p95
$173.85
p99
$204.59

50% of providers bill between $86.38 and $126.39 per claim for this code.

90% bill between $75.98 and $150.73.

Top 1% bill above $204.59.

About This Procedure

HCPCS code 99478 was billed by 55 providers across 22K claims, totaling $2.5M in Medicaid payments from 2018–2024. This code was used for 4,513 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$106.11

Providers Billing

55

National Spending

$2.5M

Avg/Median Ratio

1.03×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99478

#ProviderTotal Paid
11619987302$812K
2Neo Natal Associates Plc

Grand Rapids, MI · Pediatrics Neonatal-Perinatal Medicine

$287K
31003990318$168K
41336218726$131K
51457389033$103K
61376831636$99K
71811920549$87K
81780676650$86K
91700072964$80K
101922193911$69K
111245898683$54K
121114387206$52K
131003829441$43K
141609915784$37K
15Lsu Health Sciences Center Shreveport Faculty Group Practice

Shreveport, LA · Oral & Maxillofacial Surgery

$36K
161962522771$33K
171063964708$33K
181346284684$21K
191902949803$18K
201780848580$18K

Showing top 20 of 55 providers billing this code