99202
Office/outpatient visit, new patient, low complexity
Office/outpatient visit, new patient, low complexity is the #258 most-billed Medicaid procedure code, with $549.0M in payments across 9.4M claims from 2018–2024. The national median cost per claim is $40.11. Costs vary widely — the 90th percentile is $84.27 per claim, 2.1× the median.
Total Paid
$549.0M
0.05% of all spending
Total Claims
9.4M
Providers
16K
Avg Cost/Claim
$59
National Cost Distribution
How much do providers bill per claim for 99202? Based on 14K providers billing this code nationally.
Median
$40.11
Average
$49.52
Std Dev
$46.71
Max
$1,108.82
Percentile Distribution (Cost per Claim)
50% of providers bill between $28.11 and $56.85 per claim for this code.
90% bill between $11.86 and $84.27.
Top 1% bill above $245.71.
About This Procedure
HCPCS code 99202 (Office/outpatient visit, new patient, low complexity) was billed by 16K providers across 9.4M claims, totaling $549.0M in Medicaid payments from 2018–2024. This code was used for 8.6M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$40.11
Providers Billing
14K
National Spending
$549.0M
Avg/Median Ratio
1.23×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 99202
| # | Provider | Total Paid |
|---|---|---|
| 1 | City Medical Of Upper East Side Pllc New York, NY · Clinic/Center Urgent Care | $13.4M |
| 2 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $10.7M |
| 3 | Lasante Health Center Inc Brooklyn, NY · Clinic/Center, Community Health | $8.3M |
| 4 | 1639278369 | $7.9M |
| 5 | North Shore Lij Urgent Care P.c. Rockville Centre, NY · Clinic/Center Urgent Care | $7.9M |
| 6 | 1336153295 | $6.1M |
| 7 | Planned Parenthood/orange And San Bernardino Counties, Inc. Orange, CA · Clinic/Center, Ambulatory Family Planning Facility | $5.1M |
| 8 | Regents Of The University Of California Sacramento, CA · General Acute Care Hospital | $4.8M |
| 9 | 1396725677 | $3.9M |
| 10 | 1417959701 | $3.8M |
| 11 | 1477671535 | $3.2M |
| 12 | 1932590601 | $3.1M |
| 13 | Seattle Children's Hospital Seattle, WA · Prosthetic/Orthotic Supplier | $3.0M |
| 14 | 1073565610 | $3.0M |
| 15 | 1316005572 | $2.8M |
| 16 | Suffolk Primary Health Llc Riverhead, NY · Clinic/Center Primary Care | $2.7M |
| 17 | 1598703019 | $2.7M |
| 18 | 1689603748 | $2.6M |
| 19 | 1235120676 | $2.6M |
| 20 | 1275936932 | $2.5M |
Showing top 20 of 16K providers billing this code