99211
Office/outpatient visit, minimal complexity
Office/outpatient visit, minimal complexity is the #114 most-billed Medicaid procedure code, with $1.73B in payments across 44.1M claims from 2018–2024. The national median cost per claim is $12.93. Costs vary widely — the 90th percentile is $38.11 per claim, 2.9× the median.
Total Paid
$1.73B
0.16% of all spending
Total Claims
44.1M
Providers
20K
Avg Cost/Claim
$39
National Cost Distribution
How much do providers bill per claim for 99211? Based on 18K providers billing this code nationally.
Median
$12.93
Average
$21.52
Std Dev
$40.38
Max
$719.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $8.44 and $19.07 per claim for this code.
90% bill between $2.62 and $38.11.
Top 1% bill above $169.97.
About This Procedure
HCPCS code 99211 (Office/outpatient visit, minimal complexity) was billed by 20K providers across 44.1M claims, totaling $1.73B in Medicaid payments from 2018–2024. This code was used for 32.3M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$12.93
Providers Billing
18K
National Spending
$1.73B
Avg/Median Ratio
1.66×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 99211
| # | Provider | Total Paid |
|---|---|---|
| 1 | Dhhs Ihs Phoenix Area Whiteriver, AZ · General Acute Care Hospital | $89.2M |
| 2 | Alaska Native Tribal Health Consortium Anchorage, AK · General Acute Care Hospital | $73.5M |
| 3 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $72.4M |
| 4 | Dhhs Phs Naihs Shiprock Hospital Shiprock, NM · General Acute Care Hospital | $71.2M |
| 5 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $52.2M |
| 6 | Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital | $47.3M |
| 7 | Nyu Langone Hospitals Brooklyn, NY · General Acute Care Hospital | $45.9M |
| 8 | 1770662348 | $42.4M |
| 9 | New York Network Ipa Inc Brooklyn, NY · Exclusive Provider Organization | $34.7M |
| 10 | University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital | $26.1M |
| 11 | 1356628028 | $25.6M |
| 12 | Yuma Regional Medical Center Yuma, AZ · General Acute Care Hospital | $25.3M |
| 13 | 1881637403 | $19.8M |
| 14 | Froedtert Memorial Lutheran Hospital, Inc. Milwaukee, WI · Clinic/Center, Radiology | $17.4M |
| 15 | 1134206386 | $16.6M |
| 16 | Ohio State University Hospitals Columbus, OH · General Acute Care Hospital | $16.6M |
| 17 | Brockton Hospital, Inc. Brockton, MA · General Acute Care Hospital | $15.5M |
| 18 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $15.5M |
| 19 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $14.1M |
| 20 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $13.6M |
Showing top 20 of 20K providers billing this code