Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1309 of 11K

95716

HCPCS Procedure Code

HCPCS code 95716 is the #1,309 most-billed Medicaid procedure code, with $27.9M in payments across 37K claims from 2018–2024. The national median cost per claim is $685.48.

Total Paid

$27.9M

0.00% of all spending

Total Claims

37K

Providers

71

Avg Cost/Claim

$765

National Cost Distribution

How much do providers bill per claim for 95716? Based on 70 providers billing this code nationally.

Median

$685.48

Average

$761.22

Std Dev

$577.06

Max

$3,187.25

Percentile Distribution (Cost per Claim)

p10
$137.69
p25
$371.01
Median
$685.48
p75
$1,034.16
p90
$1,333.82
p95
$1,930.95
p99
$2,498.06

50% of providers bill between $371.01 and $1,034.16 per claim for this code.

90% bill between $137.69 and $1,333.82.

Top 1% bill above $2,498.06.

About This Procedure

HCPCS code 95716 was billed by 71 providers across 37K claims, totaling $27.9M in Medicaid payments from 2018–2024. This code was used for 23K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$685.48

Providers Billing

70

National Spending

$27.9M

Avg/Median Ratio

1.11×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 95716

#ProviderTotal Paid
11104122621$5.1M
21659849040$3.4M
31932118056$2.9M
41982666111$2.1M
5Arkansas Childrens Hospital

Little Rock, AR · Clinic/Center, Critical Access Hospital

$1.5M
61063909208$1.2M
7State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$1.1M
8Dayton Children's Hospital

Dayton, OH · General Acute Care Hospital, Children

$936K
9Children's Hospital Medical Center Of Akron

Akron, OH · General Acute Care Hospital Children

$920K
101124128103$717K
11Vhs Childrens Hospital Of Michigan Inc

Detroit, MI · Clinic/Center, Ambulatory Surgical

$675K
12Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$588K
13Connecticut Children's Medical Center

Hartford, CT · General Acute Care Hospital, Children

$559K
14Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$528K
151689765737$449K
161699286104$400K
17Seattle Children's Hospital

Seattle, WA · Prosthetic/Orthotic Supplier

$383K
18Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$370K
191518042175$365K
201730296047$313K

Showing top 20 of 71 providers billing this code