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#2148 of 11K

99495

HCPCS Procedure Code

HCPCS code 99495 is the #2,148 most-billed Medicaid procedure code, with $8.4M in payments across 107K claims from 2018–2024. The national median cost per claim is $52.75. Costs vary widely — the 90th percentile is $126.53 per claim, 2.4× the median.

Total Paid

$8.4M

0.00% of all spending

Total Claims

107K

Providers

369

Avg Cost/Claim

$79

National Cost Distribution

How much do providers bill per claim for 99495? Based on 291 providers billing this code nationally.

Median

$52.75

Average

$60.66

Std Dev

$60.37

Max

$500.00

Percentile Distribution (Cost per Claim)

p10
$3.72
p25
$14.74
Median
$52.75
p75
$85.15
p90
$126.53
p95
$155.59
p99
$230.36

50% of providers bill between $14.74 and $85.15 per claim for this code.

90% bill between $3.72 and $126.53.

Top 1% bill above $230.36.

About This Procedure

HCPCS code 99495 was billed by 369 providers across 107K claims, totaling $8.4M in Medicaid payments from 2018–2024. This code was used for 89K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$52.75

Providers Billing

291

National Spending

$8.4M

Avg/Median Ratio

1.15×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99495

#ProviderTotal Paid
11780656215$3.7M
21114656816$1.0M
31245781160$246K
41003829441$191K
5West Virginia University Medical Corporation

Morgantown, WV · Anesthesiology

$159K
61972765501$154K
71578076501$152K
81619923919$146K
91659312593$129K
10Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$127K
11Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$123K
12William Beaumont Hospital

Royal Oak, MI · Internal Medicine, Cardiovascular Disease

$99K
131083952857$96K
14The General Hospital Corporation

Boston, MA · General Acute Care Hospital

$84K
151578598868$83K
161295023547$76K
171831248236$70K
18Eastern Maine Medical Center

Bangor, ME · General Acute Care Hospital

$53K
191497047203$50K
201184849200$49K

Showing top 20 of 369 providers billing this code