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

#3344 of 11K

95076

HCPCS Procedure Code

HCPCS code 95076 is the #3,344 most-billed Medicaid procedure code, with $1.9M in payments across 16K claims from 2018–2024. The national median cost per claim is $70.83. Costs vary widely — the 90th percentile is $431.41 per claim, 6.1× the median.

Total Paid

$1.9M

0.00% of all spending

Total Claims

16K

Providers

60

Avg Cost/Claim

$119

National Cost Distribution

How much do providers bill per claim for 95076? Based on 59 providers billing this code nationally.

Median

$70.83

Average

$157.48

Std Dev

$188.41

Max

$954.00

Percentile Distribution (Cost per Claim)

p10
$13.54
p25
$50.26
Median
$70.83
p75
$214.00
p90
$431.41
p95
$504.20
p99
$758.62

50% of providers bill between $50.26 and $214.00 per claim for this code.

90% bill between $13.54 and $431.41.

Top 1% bill above $758.62.

About This Procedure

HCPCS code 95076 was billed by 60 providers across 16K claims, totaling $1.9M in Medicaid payments from 2018–2024. This code was used for 13K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$70.83

Providers Billing

59

National Spending

$1.9M

Avg/Median Ratio

2.22×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 95076

#ProviderTotal Paid
11295738003$277K
2Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$239K
3Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$211K
41144405762$173K
5The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$128K
6Children's Hospital Medical Center Of Akron

Akron, OH · General Acute Care Hospital Children

$101K
7Dayton Children's Hospital

Dayton, OH · General Acute Care Hospital, Children

$99K
8Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$75K
9Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$72K
101184048449$51K
11Spectrum Health Hospitals

Grand Rapids, MI · General Acute Care Hospital

$48K
12The Milton S Hershey Medical Center

Hershey, PA · General Acute Care Hospital

$42K
13University Physicians Incorporated

Aurora, CO · Anesthesiology

$41K
14Children's Health System Of Texas

Dallas, TX · General Acute Care Hospital Children

$35K
15Vanderbilt University Medical Center

Nashville, TN · Transplant Surgery

$32K
161477986784$26K
171336245828$25K
181881607661$21K
191750351375$20K
20Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$20K

Showing top 20 of 60 providers billing this code

Related Procedures