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#4790 of 11K

80158

HCPCS Procedure Code

HCPCS code 80158 is the #4,790 most-billed Medicaid procedure code, with $400K in payments across 40K claims from 2018–2024. The national median cost per claim is $8.27. Costs vary widely — the 90th percentile is $18.27 per claim, 2.2× the median.

Total Paid

$400K

0.00% of all spending

Total Claims

40K

Providers

68

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for 80158? Based on 68 providers billing this code nationally.

Median

$8.27

Average

$10.52

Std Dev

$9.59

Max

$70.69

Percentile Distribution (Cost per Claim)

p10
$3.60
p25
$5.75
Median
$8.27
p75
$12.66
p90
$18.27
p95
$24.13
p99
$44.10

50% of providers bill between $5.75 and $12.66 per claim for this code.

90% bill between $3.60 and $18.27.

Top 1% bill above $44.10.

About This Procedure

HCPCS code 80158 was billed by 68 providers across 40K claims, totaling $400K in Medicaid payments from 2018–2024. This code was used for 26K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$8.27

Providers Billing

68

National Spending

$400K

Avg/Median Ratio

1.27×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 80158

#ProviderTotal Paid
1Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$52K
2Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$43K
3Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$33K
41891873303$30K
5Permanente Medical Group, Inc.

Richmond, CA · Clinical Medical Laboratory

$25K
6Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$24K
71164493847$18K
8University Of Kentucky

Lexington, KY · General Acute Care Hospital

$16K
9Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$14K
10Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$13K
11The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$11K
12Seattle Children's Hospital

Seattle, WA · Prosthetic/Orthotic Supplier

$9K
13Quest Diagnostics Massachusetts Llc

Marlborough, MA · Clinical Medical Laboratory

$8K
14Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$7K
15Regents Of The University Of Michigan

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

$6K
16Laboratory Corporation Of America

San Diego, CA · Clinical Medical Laboratory

$6K
171073587937$6K
18Quest Diagnostics Clinical Laboratories Inc

Irving, TX · Clinical Medical Laboratory

$5K
19Quest Diagnostics Llc

Marlborough, MA · Clinical Medical Laboratory

$5K
201316241102$5K

Showing top 20 of 68 providers billing this code