99053
HCPCS Procedure Code
HCPCS code 99053 is the #2,450 most-billed Medicaid procedure code, with $5.7M in payments across 5.0M claims from 2018–2024. The national median cost per claim is $0.38. Costs vary widely — the 90th percentile is $10.39 per claim, 27.3× the median.
Total Paid
$5.7M
0.00% of all spending
Total Claims
5.0M
Providers
1K
Avg Cost/Claim
$1
National Cost Distribution
How much do providers bill per claim for 99053? Based on 558 providers billing this code nationally.
Median
$0.38
Average
$3.40
Std Dev
$6.46
Max
$78.97
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.03 and $5.08 per claim for this code.
90% bill between $0.01 and $10.39.
Top 1% bill above $26.75.
About This Procedure
HCPCS code 99053 was billed by 1K providers across 5.0M claims, totaling $5.7M in Medicaid payments from 2018–2024. This code was used for 4.5M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$0.38
Providers Billing
558
National Spending
$5.7M
Avg/Median Ratio
8.95×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 99053
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1568401461 | $616K |
| 2 | 1235172370 | $603K |
| 3 | 1073012696 | $374K |
| 4 | Emergency Coverage, Llc Newport, TN · Emergency Medicine | $276K |
| 5 | 1730128760 | $246K |
| 6 | 1902278906 | $244K |
| 7 | 1033133103 | $149K |
| 8 | 1578032058 | $144K |
| 9 | 1235176702 | $124K |
| 10 | 1679514467 | $121K |
| 11 | 1093723538 | $118K |
| 12 | 1437105277 | $105K |
| 13 | 1235147117 | $105K |
| 14 | 1487811048 | $100K |
| 15 | 1861480840 | $94K |
| 16 | 1528333101 | $90K |
| 17 | 1144585357 | $89K |
| 18 | Yale University New Haven, CT · Internal Medicine | $89K |
| 19 | 1518519461 | $78K |
| 20 | 1376834937 | $75K |
Showing top 20 of 1K providers billing this code