#5534 of 11K

95976

HCPCS Procedure Code

HCPCS code 95976 is the #5,534 most-billed Medicaid procedure code, with $180K in payments across 8,804 claims from 2018–2024. The national median cost per claim is $19.92. Costs vary widely — the 90th percentile is $59.64 per claim, 3.0× the median.

Total Paid

$180K

0.00% of all spending

Total Claims

8,804

Providers

Avg Cost/Claim

$20

National Cost Distribution

How much do providers bill per claim for 95976? Based on 18 providers billing this code nationally.

Median

$19.92

Average

$28.96

Std Dev

$24.67

Max

$97.22

Percentile Distribution (Cost per Claim)

p10

$14.19

p25

$16.60

Median

$19.92

p75

$24.83

p90

$59.64

p95

$88.60

p99

$95.50

50% of providers bill between $16.60 and $24.83 per claim for this code.

90% bill between $14.19 and $59.64.

Top 1% bill above $95.50.

About This Procedure

HCPCS code 95976 was billed by 19 providers across 8,804 claims, totaling $180K in Medicaid payments from 2018–2024. This code was used for 3,486 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$19.92

Providers Billing

National Spending

$180K

Avg/Median Ratio

1.45×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 95976

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1295211126	$67K	$25.61	1.3× median	Above 75th
2	1023721065	$47K	$18.56	0.9× median	Below Median
3	1588614168	$20K	$9.22	0.5× median	Below Median
4	University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital	$17K	$87.08	4.4× median	Top 10%
5	1588389944	$16K	$22.48	1.1× median	Above Median
6	1851549273	$5K	$97.22	4.9× median	Top 1%
7	1720009681	$2K	$17.88	0.9× median	Below Median
8	Broadlawns Medical Center Des Moines, IA · General Acute Care Hospital	$2K	$35.55	1.8× median	Above 75th
9	1477738128	$1K	$47.88	2.4× median	Above 75th
10	1801840434	$1K	$14.82	0.7× median	Below Median
11	1689623258	$298	$21.28	1.1× median	Above Median
12	William Beaumont Hospital Royal Oak, MI · Internal Medicine, Cardiovascular Disease	$291	$22.36	1.1× median	Above Median
13	1326123910	$291	$22.35	1.1× median	Above Median
14	1184610248	$267	$12.71	0.6× median	Below Median
15	State University Of Iowa Iowa City, IA · General Acute Care Hospital	$246	$17.60	0.9× median	Below Median
16	1417446691	$212	$16.27	0.8× median	Below Median
17	1346403854	$211	$17.57	0.9× median	Below Median
18	Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment	$178	$14.83	0.7× median	Below Median
19	1437668985	$0	$0.00	0.0× median	Below Median

Showing top 19 of 19 providers billing this code

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