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#5902 of 11K

95970

HCPCS Procedure Code

HCPCS code 95970 is the #5,902 most-billed Medicaid procedure code, with $122K in payments across 6,807 claims from 2018–2024. The national median cost per claim is $11.04. Costs vary widely — the 90th percentile is $33.51 per claim, 3.0× the median.

Total Paid

$122K

0.00% of all spending

Total Claims

6,807

Providers

71

Avg Cost/Claim

$18

National Cost Distribution

How much do providers bill per claim for 95970? Based on 69 providers billing this code nationally.

Median

$11.04

Average

$16.86

Std Dev

$17.99

Max

$105.31

Percentile Distribution (Cost per Claim)

p10
$3.80
p25
$7.31
Median
$11.04
p75
$19.61
p90
$33.51
p95
$51.28
p99
$86.77

50% of providers bill between $7.31 and $19.61 per claim for this code.

90% bill between $3.80 and $33.51.

Top 1% bill above $86.77.

About This Procedure

HCPCS code 95970 was billed by 71 providers across 6,807 claims, totaling $122K in Medicaid payments from 2018–2024. This code was used for 6,083 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.04

Providers Billing

69

National Spending

$122K

Avg/Median Ratio

1.53×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 95970

#ProviderTotal Paid
1Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$25K
21962498568$12K
3State University Of Iowa

Iowa City, IA · General Acute Care Hospital

$9K
41578792271$9K
51063453991$7K
6University Of Cincinnati Medical Center, Llc

Cincinnati, OH · General Acute Care Hospital

$6K
71245277631$6K
81891805727$5K
91104875970$4K
101376642900$4K
11Froedtert Memorial Lutheran Hospital, Inc.

Milwaukee, WI · Clinic/Center, Radiology

$4K
121265727762$3K
131356307581$2K
14University Of California Irvine

Orange, CA · General Acute Care Hospital

$2K
151477578201$2K
16Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$1K
171457729733$1K
18University Of Kentucky

Lexington, KY · General Acute Care Hospital

$1K
19University Of Utah

Salt Lake City, UT · Clinic/Center, Dental

$1K
201386089415$1K

Showing top 20 of 71 providers billing this code