96999
HCPCS Procedure Code
HCPCS code 96999 is the #4,445 most-billed Medicaid procedure code, with $587K in payments across 33K claims from 2018–2024. The national median cost per claim is $29.19. Costs vary widely — the 90th percentile is $170.86 per claim, 5.9× the median.
Total Paid
$587K
0.00% of all spending
Total Claims
33K
Providers
9
Avg Cost/Claim
$18
National Cost Distribution
How much do providers bill per claim for 96999? Based on 9 providers billing this code nationally.
Median
$29.19
Average
$69.62
Std Dev
$78.78
Max
$212.91
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.37 and $132.03 per claim for this code.
90% bill between $2.57 and $170.86.
Top 1% bill above $208.71.
About This Procedure
HCPCS code 96999 was billed by 9 providers across 33K claims, totaling $587K in Medicaid payments from 2018–2024. This code was used for 24K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$29.19
Providers Billing
9
National Spending
$587K
Avg/Median Ratio
2.39×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 96999
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1609078997 | $318K |
| 2 | 1124014741 | $189K |
| 3 | 1467070508 | $42K |
| 4 | 1063782621 | $23K |
| 5 | 1801342639 | $14K |
| 6 | Seattle Children's Hospital Seattle, WA · Prosthetic/Orthotic Supplier | $2K |
| 7 | 1225309586 | $305 |
| 8 | 1023185162 | $282 |
| 9 | 1336343268 | $92 |
Showing top 9 of 9 providers billing this code