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#7207 of 11K

95860

HCPCS Procedure Code

HCPCS code 95860 is the #7,207 most-billed Medicaid procedure code, with $25K in payments across 1,630 claims from 2018–2024. The national median cost per claim is $40.39.

Total Paid

$25K

0.00% of all spending

Total Claims

1,630

Providers

9

Avg Cost/Claim

$15

National Cost Distribution

How much do providers bill per claim for 95860? Based on 7 providers billing this code nationally.

Median

$40.39

Average

$44.75

Std Dev

$34.13

Max

$116.51

Percentile Distribution (Cost per Claim)

p10
$17.31
p25
$22.42
Median
$40.39
p75
$47.20
p90
$75.23
p95
$95.87
p99
$112.38

50% of providers bill between $22.42 and $47.20 per claim for this code.

90% bill between $17.31 and $75.23.

Top 1% bill above $112.38.

About This Procedure

HCPCS code 95860 was billed by 9 providers across 1,630 claims, totaling $25K in Medicaid payments from 2018–2024. This code was used for 1,208 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$40.39

Providers Billing

7

National Spending

$25K

Avg/Median Ratio

1.11×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 95860

#ProviderTotal Paid
1Riverside University Health Systems - Medical Center

Moreno Valley, CA · General Acute Care Hospital

$13K
2Maricopa County Special Health Care District

Phoenix, AZ · General Acute Care Hospital

$8K
31972556744$1K
41679663447$1K
51457467227$767
6St Lukes Roosevelt Hospital Center

New York, NY · Case Management

$607
71871830380$314
8Contra Costa County

Martinez, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$0
91699986331$0

Showing top 9 of 9 providers billing this code