#4115 of 11K

80351

HCPCS Procedure Code

HCPCS code 80351 is the #4,115 most-billed Medicaid procedure code, with $834K in payments across 109K claims from 2018–2024. The national median cost per claim is $5.19. Costs vary widely — the 90th percentile is $18.46 per claim, 3.6× the median.

Total Paid

$834K

0.00% of all spending

Total Claims

109K

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 80351? Based on 23 providers billing this code nationally.

Median

$5.19

Average

$8.83

Std Dev

$10.61

Max

$47.80

Percentile Distribution (Cost per Claim)

p10

$0.43

p25

$2.01

Median

$5.19

p75

$13.03

p90

$18.46

p95

$21.01

p99

$41.95

50% of providers bill between $2.01 and $13.03 per claim for this code.

90% bill between $0.43 and $18.46.

Top 1% bill above $41.95.

About This Procedure

HCPCS code 80351 was billed by 25 providers across 109K claims, totaling $834K in Medicaid payments from 2018–2024. This code was used for 67K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.19

Providers Billing

National Spending

$834K

Avg/Median Ratio

1.70×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 80351

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory	$280K	$5.49	1.1× median	Above Median
2	1598135451	$240K	$15.62	3.0× median	Above 75th
3	1982091617	$206K	$9.23	1.8× median	Above Median
4	1356645295	$29K	$15.07	2.9× median	Above 75th
5	1609273317	$23K	$4.89	0.9× median	Below Median
6	1447783923	$18K	$5.20	1.0× median	Above Median
7	1255608469	$16K	$3.31	0.6× median	Below Median
8	1396288999	$7K	$47.80	9.2× median	Top 1%
9	1205896594	$4K	$19.12	3.7× median	Top 10%
10	1215272406	$3K	$15.81	3.0× median	Above 75th
11	1598297590	$3K	$21.22	4.1× median	Top 10%
12	1538465497	$2K	$3.95	0.8× median	Below Median
13	1194971085	$1K	$0.71	0.1× median	Below Median
14	1235312026	$1K	$5.00	1.0× median	Below Median
15	1144399098	$610	$4.72	0.9× median	Below Median
16	1275971707	$528	$11.00	2.1× median	Above Median
17	1982952180	$315	$0.20	0.0× median	Below Median
18	1184612194	$192	$5.19	1.0× median	Above Median
19	1508275082	$116	$7.73	1.5× median	Above Median
20	1326430091	$111	$0.42	0.1× median	Below Median

Showing top 20 of 25 providers billing this code

Related Procedures

80348$30.7M 80361$27.2M 80346$25.6M 80354$23.2M 80349$20.1M

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