#1888 of 11K

99091

HCPCS Procedure Code

HCPCS code 99091 is the #1,888 most-billed Medicaid procedure code, with $12.2M in payments across 176K claims from 2018–2024. The national median cost per claim is $22.29. Costs vary widely — the 90th percentile is $154.73 per claim, 6.9× the median.

Total Paid

$12.2M

0.00% of all spending

Total Claims

176K

Providers

331

Avg Cost/Claim

$69

National Cost Distribution

How much do providers bill per claim for 99091? Based on 302 providers billing this code nationally.

Median

$22.29

Average

$61.35

Std Dev

$62.50

Max

$189.72

Percentile Distribution (Cost per Claim)

p10

$1.62

p25

$7.54

Median

$22.29

p75

$128.29

p90

$154.73

p95

$165.48

p99

$174.14

50% of providers bill between $7.54 and $128.29 per claim for this code.

90% bill between $1.62 and $154.73.

Top 1% bill above $174.14.

About This Procedure

HCPCS code 99091 was billed by 331 providers across 176K claims, totaling $12.2M in Medicaid payments from 2018–2024. This code was used for 159K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$22.29

Providers Billing

302

National Spending

$12.2M

Avg/Median Ratio

2.75×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 99091

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1093062937	$1.3M	$154.30	6.9× median	Above 75th
2	1043287287	$740K	$167.20	7.5× median	Top 10%
3	1417078411	$470K	$136.25	6.1× median	Above 75th
4	1962800284	$459K	$150.63	6.8× median	Above 75th
5	1225373244	$383K	$140.47	6.3× median	Above 75th
6	1104840594	$372K	$139.41	6.3× median	Above 75th
7	1932532199	$356K	$133.36	6.0× median	Above 75th
8	1235445123	$330K	$138.06	6.2× median	Above 75th
9	1073087599	$323K	$127.03	5.7× median	Above Median
10	1083101075	$271K	$89.24	4.0× median	Above Median
11	1124441423	$269K	$110.85	5.0× median	Above Median
12	1265568042	$233K	$154.11	6.9× median	Above 75th
13	1427104678	$220K	$138.25	6.2× median	Above 75th
14	1093792624	$215K	$78.85	3.5× median	Above Median
15	1427370790	$208K	$145.79	6.5× median	Above 75th
16	1346242567	$206K	$118.88	5.3× median	Above Median
17	1437422169	$177K	$166.85	7.5× median	Top 10%
18	1255518049	$173K	$140.67	6.3× median	Above 75th
19	1144976739	$154K	$134.81	6.0× median	Above 75th
20	1902221666	$148K	$148.45	6.7× median	Above 75th

Showing top 20 of 331 providers billing this code

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99082$1.6M 99090$1.1M 99100$568K 99101$0

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