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#4977 of 11K

95873

HCPCS Procedure Code

HCPCS code 95873 is the #4,977 most-billed Medicaid procedure code, with $332K in payments across 18K claims from 2018–2024. The national median cost per claim is $14.19. Costs vary widely — the 90th percentile is $66.19 per claim, 4.7× the median.

Total Paid

$332K

0.00% of all spending

Total Claims

18K

Providers

77

Avg Cost/Claim

$18

National Cost Distribution

How much do providers bill per claim for 95873? Based on 70 providers billing this code nationally.

Median

$14.19

Average

$24.49

Std Dev

$30.45

Max

$141.64

Percentile Distribution (Cost per Claim)

p10
$1.83
p25
$7.92
Median
$14.19
p75
$23.57
p90
$66.19
p95
$90.05
p99
$132.20

50% of providers bill between $7.92 and $23.57 per claim for this code.

90% bill between $1.83 and $66.19.

Top 1% bill above $132.20.

About This Procedure

HCPCS code 95873 was billed by 77 providers across 18K claims, totaling $332K in Medicaid payments from 2018–2024. This code was used for 17K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$14.19

Providers Billing

70

National Spending

$332K

Avg/Median Ratio

1.73×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 95873

#ProviderTotal Paid
1North Carolina Baptist Hospital

Winston Salem, NC · General Acute Care Hospital

$56K
21225119175$30K
3Texas Children's Hospital

Houston, TX · General Acute Care Hospital Children

$25K
4Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$23K
5Wake Forest University Health Sciences

Winston Salem, NC · Clinic/Center, Multi-Specialty

$18K
61780600825$18K
7Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$17K
81407116643$16K
9Phoenix Children's Hospital

Phoenix, AZ · Pediatrics

$15K
101821049156$12K
111518911767$10K
12Texas Children's Physician Group

Houston, TX · Pediatrics

$8K
131790719532$8K
141508266347$7K
151841573870$7K
161548344393$6K
171053641589$5K
181669617197$5K
19Montefiore Medical Center

Bronx, NY · Anesthesiology

$5K
20Vanderbilt University Medical Center

Nashville, TN · Transplant Surgery

$5K

Showing top 20 of 77 providers billing this code