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#535 of 11K

95886

HCPCS Procedure Code

HCPCS code 95886 is the #535 most-billed Medicaid procedure code, with $160.3M in payments across 1.9M claims from 2018–2024. The national median cost per claim is $67.70. Costs vary widely — the 90th percentile is $153.27 per claim, 2.3× the median.

Total Paid

$160.3M

0.01% of all spending

Total Claims

1.9M

Providers

2,698

Avg Cost/Claim

$85

National Cost Distribution

How much do providers bill per claim for 95886? Based on 2,613 providers billing this code nationally.

Median

$67.70

Average

$81.21

Std Dev

$57.38

Max

$480.01

Percentile Distribution (Cost per Claim)

p10
$25.23
p25
$42.23
Median
$67.70
p75
$105.43
p90
$153.27
p95
$188.38
p99
$276.04

50% of providers bill between $42.23 and $105.43 per claim for this code.

90% bill between $25.23 and $153.27.

Top 1% bill above $276.04.

About This Procedure

HCPCS code 95886 was billed by 2,698 providers across 1.9M claims, totaling $160.3M in Medicaid payments from 2018–2024. This code was used for 1.6M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$67.70

Providers Billing

2,613

National Spending

$160.3M

Avg/Median Ratio

1.20×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 95886

#ProviderTotal Paid
11659849040$2.4M
21730399163$2.3M
3The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$1.7M
4Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$1.5M
51376967422$1.5M
61033548581$1.4M
71447244256$1.3M
81962597492$1.3M
91275647851$1.2M
101457731242$1.2M
111760441141$1.2M
12The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$1.1M
131306094925$1.0M
14Ohio State University Hospitals

Columbus, OH · General Acute Care Hospital

$1.0M
151730813510$1.0M
161285630129$1.0M
171043497571$990K
181336319086$958K
19Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$951K
201952402612$941K

Showing top 20 of 2,698 providers billing this code

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