#3965 of 11K

80171

HCPCS Procedure Code

HCPCS code 80171 is the #3,965 most-billed Medicaid procedure code, with $975K in payments across 83K claims from 2018–2024. The national median cost per claim is $10.13. Costs vary widely — the 90th percentile is $22.33 per claim, 2.2× the median.

Total Paid

$975K

0.00% of all spending

Total Claims

83K

Providers

Avg Cost/Claim

$12

National Cost Distribution

How much do providers bill per claim for 80171? Based on 53 providers billing this code nationally.

Median

$10.13

Average

$20.90

Std Dev

$67.74

Max

$499.56

Percentile Distribution (Cost per Claim)

p10

$2.61

p25

$6.00

Median

$10.13

p75

$13.85

p90

$22.33

p95

$32.87

p99

$268.94

50% of providers bill between $6.00 and $13.85 per claim for this code.

90% bill between $2.61 and $22.33.

Top 1% bill above $268.94.

About This Procedure

HCPCS code 80171 was billed by 55 providers across 83K claims, totaling $975K in Medicaid payments from 2018–2024. This code was used for 69K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$10.13

Providers Billing

National Spending

$975K

Avg/Median Ratio

2.06×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 80171

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory	$423K	$11.30	1.1× median	Above Median
2	1043271539	$107K	$13.54	1.3× median	Above Median
3	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$79K	$9.01	0.9× median	Below Median
4	Alaska Native Tribal Health Consortium Anchorage, AK · General Acute Care Hospital	$75K	$499.56	49.3× median	Top 1%
5	1427007384	$46K	$24.16	2.4× median	Top 10%
6	Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory	$43K	$11.64	1.1× median	Above Median
7	1508996653	$36K	$10.13	1.0× median	Above Median
8	1649270257	$29K	$25.20	2.5× median	Top 10%
9	1376723320	$24K	$13.14	1.3× median	Above Median
10	1033650866	$16K	$6.15	0.6× median	Below Median
11	Brockton Hospital, Inc. Brockton, MA · General Acute Care Hospital	$13K	$8.80	0.9× median	Below Median
12	1376944793	$12K	$6.57	0.6× median	Below Median
13	1194744185	$10K	$3.00	0.3× median	Below Median
14	1306842521	$8K	$56.07	5.5× median	Top 10%
15	1598868655	$6K	$19.17	1.9× median	Above 75th
16	University Of Kentucky Lexington, KY · General Acute Care Hospital	$5K	$17.61	1.7× median	Above 75th
17	1336361575	$5K	$6.00	0.6× median	Below Median
18	1982952180	$5K	$2.51	0.2× median	Below Median
19	1427120336	$5K	$12.65	1.2× median	Above Median
20	1346247962	$4K	$17.65	1.7× median	Above 75th

Showing top 20 of 55 providers billing this code

Related Procedures

80164$12.8M 80179$6.6M 80177$4.9M 80178$3.2M 80175$1.7M

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