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#1028 of 11K

95806

HCPCS Procedure Code

HCPCS code 95806 is the #1,028 most-billed Medicaid procedure code, with $47.1M in payments across 372K claims from 2018–2024. The national median cost per claim is $64.51. Costs vary widely — the 90th percentile is $198.26 per claim, 3.1× the median.

Total Paid

$47.1M

0.00% of all spending

Total Claims

372K

Providers

1K

Avg Cost/Claim

$127

National Cost Distribution

How much do providers bill per claim for 95806? Based on 1K providers billing this code nationally.

Median

$64.51

Average

$111.25

Std Dev

$174.78

Max

$2,939.30

Percentile Distribution (Cost per Claim)

p10
$27.56
p25
$40.72
Median
$64.51
p75
$106.17
p90
$198.26
p95
$403.08
p99
$823.09

50% of providers bill between $40.72 and $106.17 per claim for this code.

90% bill between $27.56 and $198.26.

Top 1% bill above $823.09.

About This Procedure

HCPCS code 95806 was billed by 1K providers across 372K claims, totaling $47.1M in Medicaid payments from 2018–2024. This code was used for 333K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$64.51

Providers Billing

1K

National Spending

$47.1M

Avg/Median Ratio

1.72×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 95806

#ProviderTotal Paid
11467825182$3.1M
2Baystate Medical Center Inc

Springfield, MA · General Acute Care Hospital

$1.8M
3The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$1.7M
4The Cooper Health System

Camden, NJ · General Acute Care Hospital

$806K
5Inspira Medical Centers Inc.

Vineland, NJ · General Acute Care Hospital

$733K
61184097636$667K
71689672693$621K
81902815830$619K
91457992604$617K
101699074716$595K
11Carilion Medical Center

Roanoke, VA · General Acute Care Hospital

$577K
12Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$559K
13The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$555K
141356528269$525K
15Optum Medical Care Of New Jersey Pc

Secaucus, NJ · Durable Medical Equipment & Medical Supplies

$516K
161134480643$505K
171023347101$474K
181285223552$434K
191558392563$411K
201962464016$401K

Showing top 20 of 1K providers billing this code