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#4019 of 11K

80195

HCPCS Procedure Code

HCPCS code 80195 is the #4,019 most-billed Medicaid procedure code, with $925K in payments across 85K claims from 2018–2024. The national median cost per claim is $6.47. Costs vary widely — the 90th percentile is $19.22 per claim, 3.0× the median.

Total Paid

$925K

0.00% of all spending

Total Claims

85K

Providers

102

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for 80195? Based on 100 providers billing this code nationally.

Median

$6.47

Average

$10.74

Std Dev

$17.80

Max

$154.23

Percentile Distribution (Cost per Claim)

p10
$1.70
p25
$2.92
Median
$6.47
p75
$11.02
p90
$19.22
p95
$31.43
p99
$65.82

50% of providers bill between $2.92 and $11.02 per claim for this code.

90% bill between $1.70 and $19.22.

Top 1% bill above $65.82.

About This Procedure

HCPCS code 80195 was billed by 102 providers across 85K claims, totaling $925K in Medicaid payments from 2018–2024. This code was used for 56K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.47

Providers Billing

100

National Spending

$925K

Avg/Median Ratio

1.66×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 80195

#ProviderTotal Paid
1Johns Hopkins All Children's Hospital Inc

St Petersburg, FL · General Acute Care Hospital Children

$174K
2City Of Hope National Medical Center

Duarte, CA · General Acute Care Hospital

$161K
3Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$77K
4Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$39K
5Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$38K
6Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$29K
7Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$29K
8Childrens Hospital Of Philadelphia

Philadelphia, PA · General Acute Care Hospital Children

$27K
91922008150$24K
10Stanford Health Care

Stanford, CA · General Acute Care Hospital

$18K
11Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$16K
12Children's Hospital Corporation

Boston, MA · Clinic/Center

$15K
131316241102$14K
141891873303$12K
15Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$11K
16Childrens Hospital Of Los Angeles

Los Angeles, CA · Case Manager/Care Coordinator

$11K
17Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$10K
18Seattle Children's Hospital

Seattle, WA · Prosthetic/Orthotic Supplier

$9K
19Upmc Children's Hospital Of Pittsburgh

Pittsburgh, PA · Clinic/Center

$9K
201710287297$8K

Showing top 20 of 102 providers billing this code