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#316 of 11K

99472

Subsequent pediatric critical care, per day, age 2-5

Subsequent pediatric critical care, per day, age 2-5 is the #316 most-billed Medicaid procedure code, with $432.6M in payments across 1.2M claims from 2018–2024. The national median cost per claim is $307.98.

Total Paid

$432.6M

0.04% of all spending

Total Claims

1.2M

Providers

444

Avg Cost/Claim

$355

National Cost Distribution

How much do providers bill per claim for 99472? Based on 442 providers billing this code nationally.

Median

$307.98

Average

$327.88

Std Dev

$157.42

Max

$1,975.89

Percentile Distribution (Cost per Claim)

p10
$219.32
p25
$251.54
Median
$307.98
p75
$366.51
p90
$421.63
p95
$502.49
p99
$681.87

50% of providers bill between $251.54 and $366.51 per claim for this code.

90% bill between $219.32 and $421.63.

Top 1% bill above $681.87.

About This Procedure

HCPCS code 99472 (Subsequent pediatric critical care, per day, age 2-5) was billed by 444 providers across 1.2M claims, totaling $432.6M in Medicaid payments from 2018–2024. This code was used for 267K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$307.98

Providers Billing

442

National Spending

$432.6M

Avg/Median Ratio

1.06×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99472

#ProviderTotal Paid
11619987302$40.8M
21780676650$21.7M
31457396541$17.9M
41811920549$15.2M
5The Nemours Foundation

Wilmington, DE · Clinic/Center, Developmental Disabilities

$11.6M
61801869250$10.3M
7Vanderbilt University Medical Center

Nashville, TN · Transplant Surgery

$9.6M
81245898683$9.5M
91255354130$8.4M
101063419943$8.3M
11Neo Natal Associates Plc

Grand Rapids, MI · Pediatrics Neonatal-Perinatal Medicine

$8.1M
12Not Found

Unknown, Unknown · Unknown

$7.5M
131780669200$7.4M
141780800128$6.5M
151417042466$6.3M
16Texas Children's Physician Group

Houston, TX · Pediatrics

$6.0M
171326091448$5.9M
181477554814$5.8M
19University Physicians Incorporated

Aurora, CO · Anesthesiology

$5.7M
201518991413$5.6M

Showing top 20 of 444 providers billing this code