99223
Initial hospital care, per day, high complexity
Initial hospital care, per day, high complexity is the #137 most-billed Medicaid procedure code, with $1.33B in payments across 15.7M claims from 2018–2024. The national median cost per claim is $67.32.
Total Paid
$1.33B
0.12% of all spending
Total Claims
15.7M
Providers
19K
Avg Cost/Claim
$84
National Cost Distribution
How much do providers bill per claim for 99223? Based on 19K providers billing this code nationally.
Median
$67.32
Average
$76.35
Std Dev
$69.31
Max
$2,688.01
Percentile Distribution (Cost per Claim)
50% of providers bill between $41.96 and $100.41 per claim for this code.
90% bill between $24.34 and $131.97.
Top 1% bill above $219.68.
About This Procedure
HCPCS code 99223 (Initial hospital care, per day, high complexity) was billed by 19K providers across 15.7M claims, totaling $1.33B in Medicaid payments from 2018–2024. This code was used for 14.0M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$67.32
Providers Billing
19K
National Spending
$1.33B
Avg/Median Ratio
1.13×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 99223
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1578959318 | $12.3M |
| 2 | 1124374822 | $10.6M |
| 3 | 1952792475 | $7.3M |
| 4 | 1861627242 | $7.2M |
| 5 | 1083008072 | $7.2M |
| 6 | Los Angeles County Department Of Mental Health Los Angeles, CA · Clinic/Center, Mental Health (Including Community Mental Health Center) | $7.0M |
| 7 | Group Health Plan, Inc. Minneapolis, MN · Clinic/Center, Multi-Specialty | $6.3M |
| 8 | 1134742703 | $6.2M |
| 9 | Lsu Health Sciences Center Shreveport Faculty Group Practice Shreveport, LA · Oral & Maxillofacial Surgery | $5.5M |
| 10 | Community Physicians Of Indiana Inc Indianapolis, IN · Internal Medicine | $5.5M |
| 11 | William Beaumont Hospital Royal Oak, MI · Internal Medicine, Cardiovascular Disease | $5.4M |
| 12 | 1316902208 | $4.9M |
| 13 | 1023285756 | $4.7M |
| 14 | 1699157701 | $4.7M |
| 15 | Medstar Medical Group Ii Llc Baltimore, MD · General Practice | $4.6M |
| 16 | Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital | $4.2M |
| 17 | 1528650223 | $4.1M |
| 18 | 1700894466 | $4.1M |
| 19 | 1629307095 | $4.0M |
| 20 | 1952411233 | $3.8M |
Showing top 20 of 19K providers billing this code