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#4136 of 11K

95990

HCPCS Procedure Code

HCPCS code 95990 is the #4,136 most-billed Medicaid procedure code, with $817K in payments across 6,367 claims from 2018–2024. The national median cost per claim is $27.97. Costs vary widely — the 90th percentile is $209.50 per claim, 7.5× the median.

Total Paid

$817K

0.00% of all spending

Total Claims

6,367

Providers

16

Avg Cost/Claim

$128

National Cost Distribution

How much do providers bill per claim for 95990? Based on 15 providers billing this code nationally.

Median

$27.97

Average

$115.38

Std Dev

$216.01

Max

$855.83

Percentile Distribution (Cost per Claim)

p10
$8.50
p25
$13.23
Median
$27.97
p75
$112.92
p90
$209.50
p95
$411.27
p99
$766.91

50% of providers bill between $13.23 and $112.92 per claim for this code.

90% bill between $8.50 and $209.50.

Top 1% bill above $766.91.

About This Procedure

HCPCS code 95990 was billed by 16 providers across 6,367 claims, totaling $817K in Medicaid payments from 2018–2024. This code was used for 4,911 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$27.97

Providers Billing

15

National Spending

$817K

Avg/Median Ratio

4.13×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 95990

#ProviderTotal Paid
11114958584$523K
21679514509$164K
31598875460$37K
4Upmc Children's Hospital Of Pittsburgh

Pittsburgh, PA · Clinic/Center

$25K
51770528994$20K
61639135643$16K
71639523004$14K
8Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$7K
91053373480$5K
10State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$3K
111275580318$2K
121033153895$822
131831236272$305
141669571113$118
151518016823$81
16Ihc Health Services, Inc.

Salt Lake City, UT · Psychiatric Unit

$0

Showing top 16 of 16 providers billing this code