#1213 of 11K

99417

HCPCS Procedure Code

HCPCS code 99417 is the #1,213 most-billed Medicaid procedure code, with $33.2M in payments across 552K claims from 2018–2024. The national median cost per claim is $34.90. Costs vary widely — the 90th percentile is $101.54 per claim, 2.9× the median.

Total Paid

$33.2M

0.00% of all spending

Total Claims

552K

Providers

Avg Cost/Claim

$60

National Cost Distribution

How much do providers bill per claim for 99417? Based on 1K providers billing this code nationally.

Median

$34.90

Average

$47.71

Std Dev

$45.93

Max

$425.61

Percentile Distribution (Cost per Claim)

p10

$7.72

p25

$20.30

Median

$34.90

p75

$59.48

p90

$101.54

p95

$142.60

p99

$219.89

50% of providers bill between $20.30 and $59.48 per claim for this code.

90% bill between $7.72 and $101.54.

Top 1% bill above $219.89.

About This Procedure

HCPCS code 99417 was billed by 1K providers across 552K claims, totaling $33.2M in Medicaid payments from 2018–2024. This code was used for 412K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$34.90

Providers Billing

National Spending

$33.2M

Avg/Median Ratio

1.37×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99417

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1598954687	$1.3M	$82.45	2.4× median	Above 75th
2	Wake Forest University Health Sciences Winston Salem, NC · Clinic/Center, Multi-Specialty	$1.3M	$226.07	6.5× median	Top 1%
3	Children's Specialized Hospital New Brunswick, NJ · Pediatrics	$1.2M	$160.57	4.6× median	Top 10%
4	1013384866	$863K	$77.65	2.2× median	Above 75th
5	1740546399	$760K	$208.69	6.0× median	Top 10%
6	1477287290	$711K	$192.60	5.5× median	Top 10%
7	1194367755	$619K	$119.08	3.4× median	Top 10%
8	1902418965	$601K	$80.72	2.3× median	Above 75th
9	1306488762	$524K	$106.74	3.1× median	Top 10%
10	1629158126	$507K	$205.01	5.9× median	Top 10%
11	1235187311	$434K	$78.59	2.3× median	Above 75th
12	1457396541	$424K	$33.52	1.0× median	Below Median
13	1669448882	$392K	$86.48	2.5× median	Above 75th
14	1003408857	$368K	$85.40	2.4× median	Above 75th
15	1619640414	$361K	$99.31	2.8× median	Above 75th
16	1093090342	$356K	$64.16	1.8× median	Above 75th
17	1942212345	$348K	$84.10	2.4× median	Above 75th
18	1841410412	$338K	$205.10	5.9× median	Top 10%
19	1811920549	$332K	$22.19	0.6× median	Below Median
20	1306503446	$329K	$79.69	2.3× median	Above 75th

Showing top 20 of 1K providers billing this code

Related Procedures

99408$30.5M 99423Online digital E/M, 21+ min$13.6M 99407$9.2M 99421Online digital E/M, 5-10 min$6.2M 99422Online digital E/M, 11-20 min$4.2M

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