99499
Unlisted evaluation and management service
Unlisted evaluation and management service is the #511 most-billed Medicaid procedure code, with $176.4M in payments across 2.6M claims from 2018–2024. The national median cost per claim is $30.88. Costs vary widely — the 90th percentile is $73.07 per claim, 2.4× the median.
Total Paid
$176.4M
0.02% of all spending
Total Claims
2.6M
Providers
2K
Avg Cost/Claim
$67
National Cost Distribution
How much do providers bill per claim for 99499? Based on 2K providers billing this code nationally.
Median
$30.88
Average
$50.31
Std Dev
$118.10
Max
$2,411.84
Percentile Distribution (Cost per Claim)
50% of providers bill between $17.15 and $47.26 per claim for this code.
90% bill between $0.22 and $73.07.
Top 1% bill above $461.16.
About This Procedure
HCPCS code 99499 (Unlisted evaluation and management service) was billed by 2K providers across 2.6M claims, totaling $176.4M in Medicaid payments from 2018–2024. This code was used for 2.0M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$30.88
Providers Billing
2K
National Spending
$176.4M
Avg/Median Ratio
1.63×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 99499
| # | Provider | Total Paid |
|---|---|---|
| 1 | Grossmont Hospital Corporation La Mesa, CA · General Acute Care Hospital | $13.9M |
| 2 | 1972877017 | $10.5M |
| 3 | Sharp Memorial Hospital San Diego, CA · General Acute Care Hospital, Women | $7.3M |
| 4 | Sharp Chula Vista Medical Center Chula Vista, CA · General Acute Care Hospital | $7.2M |
| 5 | 1659359446 | $7.0M |
| 6 | 1043326531 | $6.1M |
| 7 | 1285015347 | $5.5M |
| 8 | 1871144725 | $4.9M |
| 9 | 1366807760 | $4.1M |
| 10 | 1679933667 | $3.7M |
| 11 | 1477827624 | $3.4M |
| 12 | 1053685289 | $3.3M |
| 13 | 1518962083 | $3.2M |
| 14 | 1194073056 | $3.0M |
| 15 | 1801861190 | $2.7M |
| 16 | 1154304475 | $2.5M |
| 17 | 1700829199 | $2.3M |
| 18 | 1841277704 | $2.3M |
| 19 | 1275724551 | $2.2M |
| 20 | Palomar Health Escondido, CA · General Acute Care Hospital | $2.0M |
Showing top 20 of 2K providers billing this code