95801
HCPCS Procedure Code
HCPCS code 95801 is the #4,295 most-billed Medicaid procedure code, with $689K in payments across 5K claims from 2018–2024. The national median cost per claim is $36.39. Costs vary widely — the 90th percentile is $515.68 per claim, 14.2× the median.
Total Paid
$689K
0.00% of all spending
Total Claims
5K
Providers
8
Avg Cost/Claim
$138
National Cost Distribution
How much do providers bill per claim for 95801? Based on 5 providers billing this code nationally.
Median
$36.39
Average
$193.32
Std Dev
$353.52
Max
$825.46
Percentile Distribution (Cost per Claim)
50% of providers bill between $28.65 and $51.02 per claim for this code.
90% bill between $26.50 and $515.68.
Top 1% bill above $794.48.
About This Procedure
HCPCS code 95801 was billed by 8 providers across 5K claims, totaling $689K in Medicaid payments from 2018–2024. This code was used for 5K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$36.39
Providers Billing
5
National Spending
$689K
Avg/Median Ratio
5.31×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 95801
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1154795888 | $684K |
| 2 | 1326043514 | $3K |
| 3 | 1124042700 | $714 |
| 4 | 1568414134 | $509 |
| 5 | 1871581314 | $326 |
| 6 | Contra Costa County Martinez, CA · Clinic/Center Federally Qualified Health Center (FQHC) | $0 |
| 7 | Contra Costa County San Pablo, CA · Clinic/Center Federally Qualified Health Center (FQHC) | $0 |
| 8 | Contra Costa County Pittsburg, CA · Clinic/Center Federally Qualified Health Center (FQHC) | $0 |
Showing top 8 of 8 providers billing this code