#2280 of 11K

99501

HCPCS Procedure Code

HCPCS code 99501 is the #2,280 most-billed Medicaid procedure code, with $7.1M in payments across 93K claims from 2018–2024. The national median cost per claim is $76.03.

Total Paid

$7.1M

0.00% of all spending

Total Claims

93K

Providers

Avg Cost/Claim

$77

National Cost Distribution

How much do providers bill per claim for 99501? Based on 91 providers billing this code nationally.

Median

$76.03

Average

$80.73

Std Dev

$73.38

Max

$406.80

Percentile Distribution (Cost per Claim)

p10

$0.01

p25

$46.23

Median

$76.03

p75

$93.74

p90

$132.82

p95

$202.16

p99

$375.44

50% of providers bill between $46.23 and $93.74 per claim for this code.

90% bill between $0.01 and $132.82.

Top 1% bill above $375.44.

About This Procedure

HCPCS code 99501 was billed by 98 providers across 93K claims, totaling $7.1M in Medicaid payments from 2018–2024. This code was used for 79K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$76.03

Providers Billing

National Spending

$7.1M

Avg/Median Ratio

1.06×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99501

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1467412296	$1.4M	$171.81	2.3× median	Top 10%
2	1588709133	$829K	$360.28	4.7× median	Top 10%
3	1184661894	$641K	$122.04	1.6× median	Above 75th
4	1124029467	$565K	$87.66	1.2× median	Above Median
5	1245272657	$477K	$46.39	0.6× median	Below Median
6	1801957576	$447K	$53.44	0.7× median	Below Median
7	1477636140	$349K	$91.04	1.2× median	Above Median
8	1730493032	$198K	$110.48	1.5× median	Above 75th
9	1972645422	$185K	$45.94	0.6× median	Below Median
10	1205912318	$138K	$89.85	1.2× median	Above Median
11	1164403358	$101K	$84.33	1.1× median	Above Median
12	1821061979	$96K	$148.03	1.9× median	Top 10%
13	1659897163	$95K	$49.38	0.6× median	Below Median
14	1881004026	$94K	$132.82	1.7× median	Top 10%
15	1386849008	$91K	$22.83	0.3× median	Below Median
16	1407243223	$88K	$13.00	0.2× median	Below Median
17	1659457778	$84K	$88.70	1.2× median	Above Median
18	1306904917	$82K	$50.20	0.7× median	Below Median
19	1285722272	$73K	$101.28	1.3× median	Above 75th
20	1992857841	$69K	$58.92	0.8× median	Below Median

Showing top 20 of 98 providers billing this code

Related Procedures

99509Home visit, assistance w/ ADLs$5.57B 99499Unlisted evaluation and management service$176.4M 99497$34.2M 99493$11.3M 99495$8.4M

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