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#513 of 11K

L8699

Prosthetic implant, not otherwise classified

Prosthetic implant, not otherwise classified is the #513 most-billed Medicaid procedure code, with $172.3M in payments across 155K claims from 2018–2024. The national median cost per claim is $389.88. Costs vary widely — the 90th percentile is $3,398.79 per claim, 8.7× the median.

Total Paid

$172.3M

0.02% of all spending

Total Claims

155K

Providers

258

Avg Cost/Claim

$1K

National Cost Distribution

How much do providers bill per claim for L8699? Based on 172 providers billing this code nationally.

Median

$389.88

Average

$1,180.86

Std Dev

$1,731.08

Max

$9,936.70

Percentile Distribution (Cost per Claim)

p10
$0.52
p25
$11.72
Median
$389.88
p75
$1,712.11
p90
$3,398.79
p95
$4,399.47
p99
$8,442.58

50% of providers bill between $11.72 and $1,712.11 per claim for this code.

90% bill between $0.52 and $3,398.79.

Top 1% bill above $8,442.58.

About This Procedure

HCPCS code L8699 (Prosthetic implant, not otherwise classified) was billed by 258 providers across 155K claims, totaling $172.3M in Medicaid payments from 2018–2024. This code was used for 122K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$389.88

Providers Billing

172

National Spending

$172.3M

Avg/Median Ratio

3.03×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for L8699

#ProviderTotal Paid
11578560447$20.4M
21326360843$15.5M
31558469403$12.0M
4Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$11.7M
51821072141$10.4M
61699713800$7.8M
71114256815$7.8M
81104856095$7.6M
91568415834$7.5M
101538475348$7.1M
111659389997$5.4M
121780681189$4.5M
131477584993$2.8M
141487057766$2.7M
15Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$2.4M
161467678409$2.2M
171720031701$2.2M
181881845022$2.2M
191043354111$2.1M
201881690949$2.0M

Showing top 20 of 258 providers billing this code