#2708 of 11K

95180

HCPCS Procedure Code

HCPCS code 95180 is the #2,708 most-billed Medicaid procedure code, with $4.0M in payments across 31K claims from 2018–2024. The national median cost per claim is $156.79. Costs vary widely — the 90th percentile is $431.73 per claim, 2.8× the median.

Total Paid

$4.0M

0.00% of all spending

Total Claims

31K

Providers

Avg Cost/Claim

$130

National Cost Distribution

How much do providers bill per claim for 95180? Based on 39 providers billing this code nationally.

Median

$156.79

Average

$201.36

Std Dev

$120.34

Max

$483.92

Percentile Distribution (Cost per Claim)

p10

$80.65

p25

$118.26

Median

$156.79

p75

$238.93

p90

$431.73

p95

$474.48

p99

$483.33

50% of providers bill between $118.26 and $238.93 per claim for this code.

90% bill between $80.65 and $431.73.

Top 1% bill above $483.33.

About This Procedure

HCPCS code 95180 was billed by 39 providers across 31K claims, totaling $4.0M in Medicaid payments from 2018–2024. This code was used for 18K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$156.79

Providers Billing

National Spending

$4.0M

Avg/Median Ratio

1.28×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 95180

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1891787289	$1.4M	$80.76	0.5× median	Below Median
2	1174575831	$764K	$262.38	1.7× median	Above 75th
3	1265422596	$442K	$133.95	0.9× median	Below Median
4	1881785947	$264K	$131.80	0.8× median	Below Median
5	1902839673	$259K	$482.37	3.1× median	Top 10%
6	1649279670	$169K	$175.18	1.1× median	Above Median
7	1679567838	$78K	$431.27	2.8× median	Above 75th
8	1013947720	$65K	$181.43	1.2× median	Above Median
9	1235468083	$52K	$119.31	0.8× median	Below Median
10	1316265010	$51K	$153.74	1.0× median	Below Median
11	1972560381	$42K	$234.56	1.5× median	Above Median
12	1912048745	$42K	$156.79	1.0× median	Below Median
13	1093015828	$42K	$473.60	3.0× median	Top 10%
14	1619037975	$33K	$296.78	1.9× median	Above 75th
15	1295738003	$32K	$145.31	0.9× median	Below Median
16	1215558341	$31K	$483.92	3.1× median	Top 1%
17	1770514945	$26K	$155.28	1.0× median	Below Median
18	1437538246	$26K	$138.12	0.9× median	Below Median
19	Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children	$24K	$352.08	2.2× median	Above 75th
20	1588956197	$23K	$82.60	0.5× median	Below Median

Showing top 20 of 39 providers billing this code

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