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#5462 of 11K

96155

HCPCS Procedure Code

HCPCS code 96155 is the #5,462 most-billed Medicaid procedure code, with $194K in payments across 6K claims from 2018–2024. The national median cost per claim is $34.72. Costs vary widely — the 90th percentile is $92.32 per claim, 2.7× the median.

Total Paid

$194K

0.00% of all spending

Total Claims

6K

Providers

15

Avg Cost/Claim

$33

National Cost Distribution

How much do providers bill per claim for 96155? Based on 13 providers billing this code nationally.

Median

$34.72

Average

$48.49

Std Dev

$31.30

Max

$105.00

Percentile Distribution (Cost per Claim)

p10
$16.93
p25
$29.59
Median
$34.72
p75
$77.07
p90
$92.32
p95
$99.36
p99
$103.87

50% of providers bill between $29.59 and $77.07 per claim for this code.

90% bill between $16.93 and $92.32.

Top 1% bill above $103.87.

About This Procedure

HCPCS code 96155 was billed by 15 providers across 6K claims, totaling $194K in Medicaid payments from 2018–2024. This code was used for 4K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$34.72

Providers Billing

13

National Spending

$194K

Avg/Median Ratio

1.40×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 96155

#ProviderTotal Paid
1Hopebridge, Llc

Kokomo, IN · Assistant Behavior Analyst

$112K
21447562434$27K
31427154814$16K
41689776718$9K
51295040525$8K
6Phoenix Children's Hospital

Phoenix, AZ · Pediatrics

$8K
71770706160$6K
81033663430$4K
9District Medical Group, Inc

Phoenix, AZ · Anesthesiology

$2K
101669513404$1K
111336245828$813
121003199712$797
13Vav Operations Llc

South Bend, IN · Community/Behavioral Health

$278
141999999976$0
151043431927$0

Showing top 15 of 15 providers billing this code