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#5860 of 11K

95125

HCPCS Procedure Code

HCPCS code 95125 is the #5,860 most-billed Medicaid procedure code, with $128K in payments across 14K claims from 2018–2024. The national median cost per claim is $8.90. Costs vary widely — the 90th percentile is $25.55 per claim, 2.9× the median.

Total Paid

$128K

0.00% of all spending

Total Claims

14K

Providers

17

Avg Cost/Claim

$9

National Cost Distribution

How much do providers bill per claim for 95125? Based on 15 providers billing this code nationally.

Median

$8.90

Average

$13.08

Std Dev

$8.39

Max

$26.04

Percentile Distribution (Cost per Claim)

p10
$6.20
p25
$7.46
Median
$8.90
p75
$21.02
p90
$25.55
p95
$26.04
p99
$26.04

50% of providers bill between $7.46 and $21.02 per claim for this code.

90% bill between $6.20 and $25.55.

Top 1% bill above $26.04.

About This Procedure

HCPCS code 95125 was billed by 17 providers across 14K claims, totaling $128K in Medicaid payments from 2018–2024. This code was used for 5,812 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$8.90

Providers Billing

15

National Spending

$128K

Avg/Median Ratio

1.47×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 95125

#ProviderTotal Paid
11215009741$80K
21730252438$17K
31124027552$8K
41952356297$8K
51306946546$3K
61508992694$2K
71720251697$2K
81083615033$2K
9Mid Atlantic Pemanente Medical Group

Rockville, MD · Health Maintenance Organization

$1K
101134219942$1K
111427668318$1K
121467454967$800
131194739268$507
141619075009$501
151336578772$441
16Southern California Permanente Medical Group

Panorama City, CA · Health Maintenance Organization

$0
171962599571$0

Showing top 17 of 17 providers billing this code