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#2768 of 11K

D5899

HCPCS Procedure Code

HCPCS code D5899 is the #2,768 most-billed Medicaid procedure code, with $3.8M in payments across 101K claims from 2018–2024. The national median cost per claim is $30.31. Costs vary widely — the 90th percentile is $235.82 per claim, 7.8× the median.

Total Paid

$3.8M

0.00% of all spending

Total Claims

101K

Providers

163

Avg Cost/Claim

$37

National Cost Distribution

How much do providers bill per claim for D5899? Based on 55 providers billing this code nationally.

Median

$30.31

Average

$98.68

Std Dev

$113.03

Max

$422.26

Percentile Distribution (Cost per Claim)

p10
$3.32
p25
$9.77
Median
$30.31
p75
$161.48
p90
$235.82
p95
$336.79
p99
$413.47

50% of providers bill between $9.77 and $161.48 per claim for this code.

90% bill between $3.32 and $235.82.

Top 1% bill above $413.47.

About This Procedure

HCPCS code D5899 was billed by 163 providers across 101K claims, totaling $3.8M in Medicaid payments from 2018–2024. This code was used for 65K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$30.31

Providers Billing

55

National Spending

$3.8M

Avg/Median Ratio

3.26×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for D5899

#ProviderTotal Paid
11205113560$915K
21699708297$887K
31114019858$197K
41891740908$197K
5Sun River Health Inc.

Peekskill, NY · Clinic/Center Federally Qualified Health Center (FQHC)

$189K
61760013700$188K
71972982007$146K
8Union Community Health Center Inc.

Bronx, NY · Clinic/Center

$123K
91699748533$103K
10Lasante Health Center Inc

Brooklyn, NY · Clinic/Center, Community Health

$99K
111184851115$95K
121760457865$94K
131083079081$86K
141912058058$81K
151932295888$76K
161407146111$44K
171992822290$35K
181619213741$34K
191972681484$29K
201114446283$18K

Showing top 20 of 163 providers billing this code