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#1297 of 11K

95813

HCPCS Procedure Code

HCPCS code 95813 is the #1,297 most-billed Medicaid procedure code, with $28.5M in payments across 135K claims from 2018–2024. The national median cost per claim is $121.48. Costs vary widely — the 90th percentile is $378.47 per claim, 3.1× the median.

Total Paid

$28.5M

0.00% of all spending

Total Claims

135K

Providers

366

Avg Cost/Claim

$211

National Cost Distribution

How much do providers bill per claim for 95813? Based on 365 providers billing this code nationally.

Median

$121.48

Average

$179.98

Std Dev

$168.72

Max

$1,088.33

Percentile Distribution (Cost per Claim)

p10
$40.58
p25
$56.18
Median
$121.48
p75
$256.76
p90
$378.47
p95
$463.41
p99
$808.11

50% of providers bill between $56.18 and $256.76 per claim for this code.

90% bill between $40.58 and $378.47.

Top 1% bill above $808.11.

About This Procedure

HCPCS code 95813 was billed by 366 providers across 135K claims, totaling $28.5M in Medicaid payments from 2018–2024. This code was used for 125K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$121.48

Providers Billing

365

National Spending

$28.5M

Avg/Median Ratio

1.48×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 95813

#ProviderTotal Paid
1Newark Beth Israel Medical Center Inc

Newark, NJ · General Acute Care Hospital

$1.9M
2The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$1.3M
3The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$997K
41689765737$903K
51912070673$875K
6Medical University Hospital Authority

Charleston, SC · General Acute Care Hospital

$850K
71124573522$808K
81780014761$796K
91679643027$730K
101790806370$661K
111033574140$640K
12The General Hospital Corporation

Boston, MA · General Acute Care Hospital

$595K
131073508545$576K
141629011234$548K
151891935862$522K
161386091486$500K
171235274200$393K
181043497571$383K
19Multicare Health System

Tacoma, WA · Community/Behavioral Health

$368K
201508808676$358K

Showing top 20 of 366 providers billing this code