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#5038 of 11K

D9991

HCPCS Procedure Code

HCPCS code D9991 is the #5,038 most-billed Medicaid procedure code, with $312K in payments across 41K claims from 2018–2024. The national median cost per claim is $9.86. Costs vary widely — the 90th percentile is $67.07 per claim, 6.8× the median.

Total Paid

$312K

0.00% of all spending

Total Claims

41K

Providers

60

Avg Cost/Claim

$8

National Cost Distribution

How much do providers bill per claim for D9991? Based on 32 providers billing this code nationally.

Median

$9.86

Average

$22.97

Std Dev

$41.96

Max

$205.47

Percentile Distribution (Cost per Claim)

p10
$1.73
p25
$3.43
Median
$9.86
p75
$11.19
p90
$67.07
p95
$98.97
p99
$173.74

50% of providers bill between $3.43 and $11.19 per claim for this code.

90% bill between $1.73 and $67.07.

Top 1% bill above $173.74.

About This Procedure

HCPCS code D9991 was billed by 60 providers across 41K claims, totaling $312K in Medicaid payments from 2018–2024. This code was used for 38K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.86

Providers Billing

32

National Spending

$312K

Avg/Median Ratio

2.33×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for D9991

#ProviderTotal Paid
11972982007$114K
21760554448$78K
31619275039$26K
41730328873$21K
51083933113$18K
61225201460$13K
71679139257$11K
8Nyu Langone Hospitals

Brooklyn, NY · General Acute Care Hospital

$11K
91669470019$7K
101306898432$3K
111437231693$3K
121295961829$2K
131700184116$1K
141013154657$977
151417967530$710
161760603906$557
171457509465$324
181831249846$322
191760912745$318
201053539650$288

Showing top 20 of 60 providers billing this code