#3903 of 11K

80331

HCPCS Procedure Code

HCPCS code 80331 is the #3,903 most-billed Medicaid procedure code, with $1.0M in payments across 457K claims from 2018–2024. The national median cost per claim is $4.36. Costs vary widely — the 90th percentile is $10.91 per claim, 2.5× the median.

Total Paid

$1.0M

0.00% of all spending

Total Claims

457K

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 80331? Based on 30 providers billing this code nationally.

Median

$4.36

Average

$5.23

Std Dev

$5.05

Max

$19.35

Percentile Distribution (Cost per Claim)

p10

$0.11

p25

$1.12

Median

$4.36

p75

$8.05

p90

$10.91

p95

$14.01

p99

$18.44

50% of providers bill between $1.12 and $8.05 per claim for this code.

90% bill between $0.11 and $10.91.

Top 1% bill above $18.44.

About This Procedure

HCPCS code 80331 was billed by 36 providers across 457K claims, totaling $1.0M in Medicaid payments from 2018–2024. This code was used for 411K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$4.36

Providers Billing

National Spending

$1.0M

Avg/Median Ratio

1.20×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 80331

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$753K	$5.44	1.2× median	Above Median
2	1215914288	$99K	$2.63	0.6× median	Below Median
3	1508895640	$61K	$10.87	2.5× median	Above 75th
4	1487639381	$41K	$4.26	1.0× median	Below Median
5	1366433195	$17K	$10.12	2.3× median	Above 75th
6	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$12K	$4.77	1.1× median	Above Median
7	1427095488	$11K	$19.35	4.4× median	Top 1%
8	1104829159	$6K	$1.06	0.2× median	Below Median
9	1437135886	$6K	$7.92	1.8× median	Above Median
10	1568446755	$6K	$10.75	2.5× median	Above 75th
11	Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory	$4K	$2.10	0.5× median	Below Median
12	1215272406	$3K	$16.21	3.7× median	Top 10%
13	Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory	$3K	$0.15	0.0× median	Below Median
14	1043641897	$3K	$11.33	2.6× median	Top 10%
15	Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory	$3K	$0.02	0.0× median	Below Median
16	Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory	$2K	$0.39	0.1× median	Below Median
17	1285007989	$2K	$5.24	1.2× median	Above Median
18	Southern Ohio Medical Center Portsmouth, OH · Clinical Medical Laboratory	$2K	$7.97	1.8× median	Above Median
19	1346247962	$1K	$1.93	0.4× median	Below Median
20	Laboratory Corporation Of America Houston, TX · Clinical Medical Laboratory	$595	$1.28	0.3× median	Below Median

Showing top 20 of 36 providers billing this code

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