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#3476 of 11K

95943

HCPCS Procedure Code

HCPCS code 95943 is the #3,476 most-billed Medicaid procedure code, with $1.6M in payments across 32K claims from 2018–2024. The national median cost per claim is $39.91. Costs vary widely — the 90th percentile is $99.88 per claim, 2.5× the median.

Total Paid

$1.6M

0.00% of all spending

Total Claims

32K

Providers

190

Avg Cost/Claim

$50

National Cost Distribution

How much do providers bill per claim for 95943? Based on 181 providers billing this code nationally.

Median

$39.91

Average

$44.73

Std Dev

$34.34

Max

$154.93

Percentile Distribution (Cost per Claim)

p10
$5.65
p25
$14.72
Median
$39.91
p75
$66.57
p90
$99.88
p95
$109.20
p99
$121.89

50% of providers bill between $14.72 and $66.57 per claim for this code.

90% bill between $5.65 and $99.88.

Top 1% bill above $121.89.

About This Procedure

HCPCS code 95943 was billed by 190 providers across 32K claims, totaling $1.6M in Medicaid payments from 2018–2024. This code was used for 29K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$39.91

Providers Billing

181

National Spending

$1.6M

Avg/Median Ratio

1.12×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 95943

#ProviderTotal Paid
11083672133$121K
21619977030$102K
31609921378$88K
41891834552$72K
51700914033$68K
61184766107$57K
71649538109$56K
81275916652$54K
91073946588$47K
101255449229$46K
111356831309$44K
121124003488$41K
131962889451$39K
141891190195$39K
151306809397$36K
161306946579$35K
171033125844$35K
18New York Network Ipa Inc

Brooklyn, NY · Exclusive Provider Organization

$33K
191770861031$32K
201831115179$30K

Showing top 20 of 190 providers billing this code