Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#397 of 11K

99480

Subsequent intensive care, very low birth weight infant

Subsequent intensive care, very low birth weight infant is the #397 most-billed Medicaid procedure code, with $273.2M in payments across 2.7M claims from 2018–2024. The national median cost per claim is $98.15.

Total Paid

$273.2M

0.02% of all spending

Total Claims

2.7M

Providers

835

Avg Cost/Claim

$103

National Cost Distribution

How much do providers bill per claim for 99480? Based on 834 providers billing this code nationally.

Median

$98.15

Average

$100.90

Std Dev

$34.03

Max

$615.72

Percentile Distribution (Cost per Claim)

p10
$73.21
p25
$79.30
Median
$98.15
p75
$114.40
p90
$128.75
p95
$146.48
p99
$189.65

50% of providers bill between $79.30 and $114.40 per claim for this code.

90% bill between $73.21 and $128.75.

Top 1% bill above $189.65.

About This Procedure

HCPCS code 99480 (Subsequent intensive care, very low birth weight infant) was billed by 835 providers across 2.7M claims, totaling $273.2M in Medicaid payments from 2018–2024. This code was used for 804K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$98.15

Providers Billing

834

National Spending

$273.2M

Avg/Median Ratio

1.03×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99480

#ProviderTotal Paid
11649377359$10.9M
2Magella Medical Associates Billing, Inc.

Round Rock, TX · Obstetrics & Gynecology, Maternal & Fetal Medicine

$8.4M
31407957152$6.8M
41457396541$6.0M
51992802607$5.9M
61467559179$4.9M
71497852107$4.9M
81225085715$4.8M
91780676650$4.5M
10Neo Natal Associates Plc

Grand Rapids, MI · Pediatrics Neonatal-Perinatal Medicine

$4.1M
111144327859$4.0M
121720185432$3.7M
131750351375$3.6M
141992809412$3.4M
151376831636$3.3M
161235236944$3.3M
171477554814$3.1M
181255354130$3.1M
191558468256$3.1M
201922193911$2.9M

Showing top 20 of 835 providers billing this code