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#313 of 11K

95165

Professional services for allergen immunotherapy, per injection

Professional services for allergen immunotherapy, per injection is the #313 most-billed Medicaid procedure code, with $434.2M in payments across 2.9M claims from 2018–2024. The national median cost per claim is $144.04. Costs vary widely — the 90th percentile is $292.32 per claim, 2.0× the median.

Total Paid

$434.2M

0.04% of all spending

Total Claims

2.9M

Providers

2K

Avg Cost/Claim

$148

National Cost Distribution

How much do providers bill per claim for 95165? Based on 2K providers billing this code nationally.

Median

$144.04

Average

$162.82

Std Dev

$136.21

Max

$2,086.38

Percentile Distribution (Cost per Claim)

p10
$32.05
p25
$78.19
Median
$144.04
p75
$219.08
p90
$292.32
p95
$339.73
p99
$536.09

50% of providers bill between $78.19 and $219.08 per claim for this code.

90% bill between $32.05 and $292.32.

Top 1% bill above $536.09.

About This Procedure

HCPCS code 95165 (Professional services for allergen immunotherapy, per injection) was billed by 2K providers across 2.9M claims, totaling $434.2M in Medicaid payments from 2018–2024. This code was used for 1.8M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$144.04

Providers Billing

2K

National Spending

$434.2M

Avg/Median Ratio

1.13×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 95165

#ProviderTotal Paid
11376598326$16.7M
21881785947$15.2M
31306078514$15.0M
41073508347$9.7M
51215995444$5.7M
61841484235$5.0M
71821288606$4.5M
81770594129$4.5M
91134153083$4.3M
101639306731$4.3M
111093779696$4.1M
121700882388$3.8M
131184789653$3.7M
141679609465$3.5M
151891834552$3.5M
161912089335$3.3M
171487611844$3.2M
181235843608$3.0M
191033139498$2.9M
201467656009$2.9M

Showing top 20 of 2K providers billing this code

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