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#2353 of 11K

99491

HCPCS Procedure Code

HCPCS code 99491 is the #2,353 most-billed Medicaid procedure code, with $6.5M in payments across 334K claims from 2018–2024. The national median cost per claim is $9.86. Costs vary widely — the 90th percentile is $54.80 per claim, 5.6× the median.

Total Paid

$6.5M

0.00% of all spending

Total Claims

334K

Providers

649

Avg Cost/Claim

$19

National Cost Distribution

How much do providers bill per claim for 99491? Based on 552 providers billing this code nationally.

Median

$9.86

Average

$18.44

Std Dev

$23.78

Max

$113.60

Percentile Distribution (Cost per Claim)

p10
$0.70
p25
$2.86
Median
$9.86
p75
$20.79
p90
$54.80
p95
$73.11
p99
$99.49

50% of providers bill between $2.86 and $20.79 per claim for this code.

90% bill between $0.70 and $54.80.

Top 1% bill above $99.49.

About This Procedure

HCPCS code 99491 was billed by 649 providers across 334K claims, totaling $6.5M in Medicaid payments from 2018–2024. This code was used for 307K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.86

Providers Billing

552

National Spending

$6.5M

Avg/Median Ratio

1.87×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 99491

#ProviderTotal Paid
11003836545$441K
21811449697$387K
31588244750$366K
41245859388$238K
51366544710$220K
61467878363$201K
71770547523$189K
81053344473$189K
91457392862$183K
101154357689$177K
111306864947$172K
121659540870$171K
131033704630$161K
141538642996$141K
151710336094$139K
161154421246$127K
171932708492$117K
181710927306$101K
191760014120$99K
201093744856$77K

Showing top 20 of 649 providers billing this code