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#5147 of 11K

G9916

HCPCS Procedure Code

HCPCS code G9916 is the #5,147 most-billed Medicaid procedure code, with $276K in payments across 300K claims from 2018–2024. The national median cost per claim is $0.42. Costs vary widely — the 90th percentile is $1.19 per claim, 2.8× the median.

Total Paid

$276K

0.00% of all spending

Total Claims

300K

Providers

103

Avg Cost/Claim

$1

National Cost Distribution

How much do providers bill per claim for G9916? Based on 6 providers billing this code nationally.

Median

$0.42

Average

$0.54

Std Dev

$0.55

Max

$1.27

Percentile Distribution (Cost per Claim)

p10
$0.02
p25
$0.07
Median
$0.42
p75
$0.99
p90
$1.19
p95
$1.23
p99
$1.26

50% of providers bill between $0.07 and $0.99 per claim for this code.

90% bill between $0.02 and $1.19.

Top 1% bill above $1.26.

About This Procedure

HCPCS code G9916 was billed by 103 providers across 300K claims, totaling $276K in Medicaid payments from 2018–2024. This code was used for 207K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.42

Providers Billing

6

National Spending

$276K

Avg/Median Ratio

1.29×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G9916

#ProviderTotal Paid
11588689483$271K
21376894931$4K
31457457814$260
41194718346$248
51245630557$80
61659452027$16
71942799747$0
81144973850$0
91932202074$0
101598141319$0
111548538739$0
121790734689$0
131376575886$0
141265758080$0
151689618407$0
161891867859$0
171578757803$0
181518408996$0
191497983662$0
201568419240$0

Showing top 20 of 103 providers billing this code