Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#5370 of 11K

Z9559

HCPCS Procedure Code

HCPCS code Z9559 is the #5,370 most-billed Medicaid procedure code, with $217K in payments across 231 claims from 2018–2024. The national median cost per claim is $631.46. Costs vary widely — the 90th percentile is $1,753.14 per claim, 2.8× the median.

Total Paid

$217K

0.00% of all spending

Total Claims

231

Providers

3

Avg Cost/Claim

$941

National Cost Distribution

How much do providers bill per claim for Z9559? Based on 3 providers billing this code nationally.

Median

$631.46

Average

$1,046.27

Std Dev

$858.64

Max

$2,033.56

Percentile Distribution (Cost per Claim)

p10
$505.32
p25
$552.62
Median
$631.46
p75
$1,332.51
p90
$1,753.14
p95
$1,893.35
p99
$2,005.51

50% of providers bill between $552.62 and $1,332.51 per claim for this code.

90% bill between $505.32 and $1,753.14.

Top 1% bill above $2,005.51.

About This Procedure

HCPCS code Z9559 was billed by 3 providers across 231 claims, totaling $217K in Medicaid payments from 2018–2024. This code was used for 222 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$631.46

Providers Billing

3

National Spending

$217K

Avg/Median Ratio

1.66×

Moderately skewed

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.