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

#5648 of 11K

95851

HCPCS Procedure Code

HCPCS code 95851 is the #5,648 most-billed Medicaid procedure code, with $161K in payments across 29K claims from 2018–2024. The national median cost per claim is $6.72. Costs vary widely — the 90th percentile is $18.77 per claim, 2.8× the median.

Total Paid

$161K

0.00% of all spending

Total Claims

29K

Providers

79

Avg Cost/Claim

$5

National Cost Distribution

How much do providers bill per claim for 95851? Based on 66 providers billing this code nationally.

Median

$6.72

Average

$7.64

Std Dev

$6.89

Max

$27.16

Percentile Distribution (Cost per Claim)

p10
$0.21
p25
$1.26
Median
$6.72
p75
$9.84
p90
$18.77
p95
$21.86
p99
$25.79

50% of providers bill between $1.26 and $9.84 per claim for this code.

90% bill between $0.21 and $18.77.

Top 1% bill above $25.79.

About This Procedure

HCPCS code 95851 was billed by 79 providers across 29K claims, totaling $161K in Medicaid payments from 2018–2024. This code was used for 20K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.72

Providers Billing

66

National Spending

$161K

Avg/Median Ratio

1.14×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 95851

#ProviderTotal Paid
11982793733$55K
21265564900$18K
31245572866$11K
41033425350$8K
51780971523$7K
61811271299$7K
71083685986$6K
8Bexar County Hospital District

San Antonio, TX · Clinical Medical Laboratory

$5K
91568739423$4K
101215306535$4K
111326256041$3K
121528546108$3K
131629409933$3K
141538234364$2K
151730359084$2K
161235332396$2K
171609471929$2K
181790771889$1K
191124468657$1K
201912166075$1K

Showing top 20 of 79 providers billing this code

Related Procedures