80055
HCPCS Procedure Code
HCPCS code 80055 is the #1,404 most-billed Medicaid procedure code, with $24.2M in payments across 931K claims from 2018–2024. The national median cost per claim is $28.10. Costs vary widely — the 90th percentile is $61.42 per claim, 2.2× the median.
Total Paid
$24.2M
0.00% of all spending
Total Claims
931K
Providers
464
Avg Cost/Claim
$26
National Cost Distribution
How much do providers bill per claim for 80055? Based on 419 providers billing this code nationally.
Median
$28.10
Average
$34.05
Std Dev
$34.59
Max
$386.64
Percentile Distribution (Cost per Claim)
50% of providers bill between $15.53 and $39.71 per claim for this code.
90% bill between $6.17 and $61.42.
Top 1% bill above $175.35.
About This Procedure
HCPCS code 80055 was billed by 464 providers across 931K claims, totaling $24.2M in Medicaid payments from 2018–2024. This code was used for 852K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$28.10
Providers Billing
419
National Spending
$24.2M
Avg/Median Ratio
1.21×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 80055
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $3.6M |
| 2 | Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory | $1.7M |
| 3 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $1.6M |
| 4 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $1.4M |
| 5 | Laboratory Corporation Of America Seattle, WA · Clinical Medical Laboratory | $835K |
| 6 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $731K |
| 7 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $560K |
| 8 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $515K |
| 9 | 1083678205 | $511K |
| 10 | 1891731626 | $502K |
| 11 | 1710916945 | $471K |
| 12 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $463K |
| 13 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $446K |
| 14 | 1548370745 | $442K |
| 15 | 1164657318 | $393K |
| 16 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $381K |
| 17 | 1700913118 | $380K |
| 18 | 1235265851 | $366K |
| 19 | 1881626943 | $339K |
| 20 | Primex Clinical Laboratories Inc. Van Nuys, CA · Clinical Medical Laboratory | $294K |
Showing top 20 of 464 providers billing this code