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#6218 of 11K

95972

HCPCS Procedure Code

HCPCS code 95972 is the #6,218 most-billed Medicaid procedure code, with $83K in payments across 2,124 claims from 2018–2024. The national median cost per claim is $23.51. Costs vary widely — the 90th percentile is $64.33 per claim, 2.7× the median.

Total Paid

$83K

0.00% of all spending

Total Claims

2,124

Providers

13

Avg Cost/Claim

$39

National Cost Distribution

How much do providers bill per claim for 95972? Based on 12 providers billing this code nationally.

Median

$23.51

Average

$38.69

Std Dev

$50.18

Max

$186.46

Percentile Distribution (Cost per Claim)

p10
$7.08
p25
$10.55
Median
$23.51
p75
$38.53
p90
$64.33
p95
$120.05
p99
$173.18

50% of providers bill between $10.55 and $38.53 per claim for this code.

90% bill between $7.08 and $64.33.

Top 1% bill above $173.18.

About This Procedure

HCPCS code 95972 was billed by 13 providers across 2,124 claims, totaling $83K in Medicaid payments from 2018–2024. This code was used for 1,795 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$23.51

Providers Billing

12

National Spending

$83K

Avg/Median Ratio

1.65×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 95972

#ProviderTotal Paid
11396124293$66K
21659431443$6K
31629053806$5K
4Ohiohealth Corporation

Columbus, OH · General Acute Care Hospital

$3K
51356569388$920
6Phoenix Children's Hospital

Phoenix, AZ · Pediatrics

$389
71316036353$308
81215003066$262
91548327273$223
101770808883$140
111275564098$85
121336319086$23
131154481984$0

Showing top 13 of 13 providers billing this code