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#4726 of 11K

99359

HCPCS Procedure Code

HCPCS code 99359 is the #4,726 most-billed Medicaid procedure code, with $431K in payments across 31K claims from 2018–2024. The national median cost per claim is $10.39. Costs vary widely — the 90th percentile is $44.80 per claim, 4.3× the median.

Total Paid

$431K

0.00% of all spending

Total Claims

31K

Providers

39

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for 99359? Based on 19 providers billing this code nationally.

Median

$10.39

Average

$16.95

Std Dev

$16.04

Max

$47.27

Percentile Distribution (Cost per Claim)

p10
$2.65
p25
$4.75
Median
$10.39
p75
$28.76
p90
$44.80
p95
$45.67
p99
$46.95

50% of providers bill between $4.75 and $28.76 per claim for this code.

90% bill between $2.65 and $44.80.

Top 1% bill above $46.95.

About This Procedure

HCPCS code 99359 was billed by 39 providers across 31K claims, totaling $431K in Medicaid payments from 2018–2024. This code was used for 5K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$10.39

Providers Billing

19

National Spending

$431K

Avg/Median Ratio

1.63×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 99359

#ProviderTotal Paid
11114483864$381K
21235383977$10K
31780098228$8K
41417409905$8K
5Mainegeneral Medical Center

Augusta, ME · General Acute Care Hospital

$7K
61477027381$4K
71467709451$3K
81366575755$2K
91902149776$2K
101689604142$2K
111407483175$1K
121376598714$591
131063468627$476
141801325634$382
15Viaquest Psychiatric & Behavioral Solutions Llc

Dublin, OH · Community/Behavioral Health

$319
161023478641$302
17District Medical Group, Inc

Phoenix, AZ · Anesthesiology

$147
181053347369$42
191023151735$8
201003282567$0

Showing top 20 of 39 providers billing this code