#1034 of 11K

99188

HCPCS Procedure Code

HCPCS code 99188 is the #1,034 most-billed Medicaid procedure code, with $46.7M in payments across 3.9M claims from 2018–2024. The national median cost per claim is $12.80.

Total Paid

$46.7M

0.00% of all spending

Total Claims

3.9M

Providers

Avg Cost/Claim

$12

National Cost Distribution

How much do providers bill per claim for 99188? Based on 3K providers billing this code nationally.

Median

$12.80

Average

$13.95

Std Dev

$14.31

Max

$597.32

Percentile Distribution (Cost per Claim)

p10

$2.26

p25

$7.18

Median

$12.80

p75

$18.98

p90

$24.85

p95

$26.13

p99

$46.37

50% of providers bill between $7.18 and $18.98 per claim for this code.

90% bill between $2.26 and $24.85.

Top 1% bill above $46.37.

About This Procedure

HCPCS code 99188 was billed by 4K providers across 3.9M claims, totaling $46.7M in Medicaid payments from 2018–2024. This code was used for 3.7M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.80

Providers Billing

National Spending

$46.7M

Avg/Median Ratio

1.09×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99188

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1437605532	$812K	$68.94	5.4× median	Top 1%
2	1669404018	$736K	$22.21	1.7× median	Above 75th
3	Park Nicollet Clinic St Louis Park, MN · Obstetrics & Gynecology	$621K	$11.24	0.9× median	Below Median
4	1184016941	$614K	$15.23	1.2× median	Above Median
5	Group Health Plan, Inc. Minneapolis, MN · Clinic/Center, Multi-Specialty	$606K	$8.28	0.6× median	Below Median
6	1568576056	$536K	$18.31	1.4× median	Above Median
7	1104005594	$441K	$17.84	1.4× median	Above Median
8	1306805056	$328K	$16.06	1.3× median	Above Median
9	1265499628	$325K	$18.83	1.5× median	Above Median
10	1063507747	$307K	$18.40	1.4× median	Above Median
11	1548486244	$299K	$26.70	2.1× median	Top 10%
12	Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital	$292K	$12.89	1.0× median	Above Median
13	Saltzman Tanis Pittell Levin And Jacobson Hollywood, FL · Pediatrics	$285K	$6.45	0.5× median	Below Median
14	Prisma Health University Medical Group Greenville, SC · Internal Medicine	$280K	$14.69	1.1× median	Above Median
15	1639257215	$265K	$21.32	1.7× median	Above 75th
16	1730123472	$261K	$21.19	1.7× median	Above 75th
17	1689852071	$249K	$7.45	0.6× median	Below Median
18	Nationwide Children's Hospital Columbus, OH · Clinic/Center Multi-Specialty	$248K	$22.50	1.8× median	Above 75th
19	1235182221	$247K	$12.19	1.0× median	Below Median
20	1982607537	$243K	$25.29	2.0× median	Top 10%

Showing top 20 of 4K providers billing this code

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