#3791 of 11K

95018

HCPCS Procedure Code

HCPCS code 95018 is the #3,791 most-billed Medicaid procedure code, with $1.2M in payments across 26K claims from 2018–2024. The national median cost per claim is $38.71. Costs vary widely — the 90th percentile is $181.27 per claim, 4.7× the median.

Total Paid

$1.2M

0.00% of all spending

Total Claims

26K

Providers

Avg Cost/Claim

$44

National Cost Distribution

How much do providers bill per claim for 95018? Based on 43 providers billing this code nationally.

Median

$38.71

Average

$76.70

Std Dev

$94.89

Max

$469.07

Percentile Distribution (Cost per Claim)

p10

$8.07

p25

$20.65

Median

$38.71

p75

$116.24

p90

$181.27

p95

$215.53

p99

$417.84

50% of providers bill between $20.65 and $116.24 per claim for this code.

90% bill between $8.07 and $181.27.

Top 1% bill above $417.84.

About This Procedure

HCPCS code 95018 was billed by 45 providers across 26K claims, totaling $1.2M in Medicaid payments from 2018–2024. This code was used for 22K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$38.71

Providers Billing

National Spending

$1.2M

Avg/Median Ratio

1.98×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 95018

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1376845453	$285K	$216.08	5.6× median	Top 10%
2	1750309589	$205K	$17.48	0.5× median	Below Median
3	1982828554	$157K	$210.59	5.4× median	Top 10%
4	1033328786	$140K	$37.10	1.0× median	Below Median
5	1558392563	$52K	$120.37	3.1× median	Above 75th
6	1679528426	$40K	$22.06	0.6× median	Below Median
7	1477986784	$36K	$30.75	0.8× median	Below Median
8	1083653752	$32K	$176.04	4.5× median	Above 75th
9	1881607661	$31K	$127.28	3.3× median	Above 75th
10	1396944799	$23K	$55.25	1.4× median	Above Median
11	North Shore-lij Medical Pc Great Neck, NY · Urology	$21K	$56.40	1.5× median	Above Median
12	1740215771	$15K	$54.67	1.4× median	Above Median
13	Novant Health New Hanover Regional Medical Center Llc Wilmington, NC · Psychiatric Unit	$14K	$469.07	12.1× median	Top 1%
14	Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent	$12K	$125.90	3.3× median	Above 75th
15	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$11K	$30.40	0.8× median	Below Median
16	1821379058	$10K	$52.77	1.4× median	Above Median
17	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$8K	$182.57	4.7× median	Top 10%
18	Montefiore Medical Center Bronx, NY · Anesthesiology	$8K	$33.28	0.9× median	Below Median
19	1720388689	$7K	$8.32	0.2× median	Below Median
20	1427170216	$6K	$20.14	0.5× median	Below Median

Showing top 20 of 45 providers billing this code

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