97799
HCPCS Procedure Code
HCPCS code 97799 is the #919 most-billed Medicaid procedure code, with $58.6M in payments across 2.1M claims from 2018–2024. The national median cost per claim is $16.72. Costs vary widely — the 90th percentile is $53.61 per claim, 3.2× the median.
Total Paid
$58.6M
0.01% of all spending
Total Claims
2.1M
Providers
563
Avg Cost/Claim
$28
National Cost Distribution
How much do providers bill per claim for 97799? Based on 528 providers billing this code nationally.
Median
$16.72
Average
$26.44
Std Dev
$25.47
Max
$255.69
Percentile Distribution (Cost per Claim)
50% of providers bill between $10.11 and $40.99 per claim for this code.
90% bill between $4.98 and $53.61.
Top 1% bill above $112.72.
About This Procedure
HCPCS code 97799 was billed by 563 providers across 2.1M claims, totaling $58.6M in Medicaid payments from 2018–2024. This code was used for 626K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$16.72
Providers Billing
528
National Spending
$58.6M
Avg/Median Ratio
1.58×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 97799
| # | Provider | Total Paid |
|---|---|---|
| 1 | West Coast Spine Restoration Center Inc Riverside, CA · Physical Therapist | $7.9M |
| 2 | 1871172957 | $7.7M |
| 3 | 1134255037 | $4.5M |
| 4 | 1124427430 | $2.6M |
| 5 | 1427181007 | $1.6M |
| 6 | 1699791897 | $1.2M |
| 7 | 1871144725 | $969K |
| 8 | 1467573642 | $911K |
| 9 | 1780687327 | $910K |
| 10 | 1649682352 | $886K |
| 11 | 1003820861 | $831K |
| 12 | 1497754378 | $663K |
| 13 | County Of Ventura Ventura, CA · Clinic/Center, Emergency Care | $657K |
| 14 | 1932361763 | $655K |
| 15 | 1952394603 | $636K |
| 16 | Childrens Hospital Of Los Angeles Los Angeles, CA · Case Manager/Care Coordinator | $597K |
| 17 | 1235331794 | $490K |
| 18 | 1508979162 | $490K |
| 19 | 1245200518 | $463K |
| 20 | Grossmont Hospital Corporation La Mesa, CA · General Acute Care Hospital | $434K |
Showing top 20 of 563 providers billing this code