#1934 of 11K

99493

HCPCS Procedure Code

HCPCS code 99493 is the #1,934 most-billed Medicaid procedure code, with $11.3M in payments across 186K claims from 2018–2024. The national median cost per claim is $73.13.

Total Paid

$11.3M

0.00% of all spending

Total Claims

186K

Providers

317

Avg Cost/Claim

$61

National Cost Distribution

How much do providers bill per claim for 99493? Based on 281 providers billing this code nationally.

Median

$73.13

Average

$70.53

Std Dev

$42.53

Max

$226.98

Percentile Distribution (Cost per Claim)

p10

$10.26

p25

$35.05

Median

$73.13

p75

$103.12

p90

$124.83

p95

$132.92

p99

$155.69

50% of providers bill between $35.05 and $103.12 per claim for this code.

90% bill between $10.26 and $124.83.

Top 1% bill above $155.69.

About This Procedure

HCPCS code 99493 was billed by 317 providers across 186K claims, totaling $11.3M in Medicaid payments from 2018–2024. This code was used for 160K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$73.13

Providers Billing

281

National Spending

$11.3M

Avg/Median Ratio

0.96×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99493

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1245795459	$1.7M	$101.47	1.4× median	Above Median
2	1821316290	$611K	$79.09	1.1× median	Above Median
3	1578595971	$562K	$75.48	1.0× median	Above Median
4	1710336094	$476K	$108.79	1.5× median	Above 75th
5	1376014076	$418K	$111.27	1.5× median	Above 75th
6	1649538109	$274K	$56.41	0.8× median	Below Median
7	1225356157	$253K	$65.85	0.9× median	Below Median
8	1821538877	$211K	$58.14	0.8× median	Below Median
9	1215205539	$190K	$83.90	1.1× median	Above Median
10	1417409905	$178K	$68.84	0.9× median	Below Median
11	1881144590	$165K	$99.82	1.4× median	Above Median
12	1043849896	$150K	$141.18	1.9× median	Top 10%
13	1447643853	$149K	$28.26	0.4× median	Below Median
14	1699724039	$147K	$129.53	1.8× median	Top 10%
15	1760407571	$142K	$149.70	2.0× median	Top 10%
16	1669402848	$141K	$56.19	0.8× median	Below Median
17	1174884258	$129K	$76.61	1.0× median	Above Median
18	1043376973	$124K	$59.55	0.8× median	Below Median
19	Sun River Health Inc. Peekskill, NY · Clinic/Center Federally Qualified Health Center (FQHC)	$124K	$90.28	1.2× median	Above Median
20	1366472326	$122K	$57.44	0.8× median	Below Median

Showing top 20 of 317 providers billing this code

Related Procedures

99490Chronic care management services, 20 minutes per month$315.0M 99499Unlisted evaluation and management service$176.4M 99497$34.2M 99484$21.3M 99487$9.3M

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