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#1688 of 11K

80359

HCPCS Procedure Code

HCPCS code 80359 is the #1,688 most-billed Medicaid procedure code, with $16.0M in payments across 3.4M claims from 2018–2024. The national median cost per claim is $4.98. Costs vary widely — the 90th percentile is $14.08 per claim, 2.8× the median.

Total Paid

$16.0M

0.00% of all spending

Total Claims

3.4M

Providers

435

Avg Cost/Claim

$5

National Cost Distribution

How much do providers bill per claim for 80359? Based on 369 providers billing this code nationally.

Median

$4.98

Average

$7.59

Std Dev

$10.95

Max

$114.75

Percentile Distribution (Cost per Claim)

p10
$0.61
p25
$2.18
Median
$4.98
p75
$9.36
p90
$14.08
p95
$16.64
p99
$63.17

50% of providers bill between $2.18 and $9.36 per claim for this code.

90% bill between $0.61 and $14.08.

Top 1% bill above $63.17.

About This Procedure

HCPCS code 80359 was billed by 435 providers across 3.4M claims, totaling $16.0M in Medicaid payments from 2018–2024. This code was used for 2.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$4.98

Providers Billing

369

National Spending

$16.0M

Avg/Median Ratio

1.52×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 80359

#ProviderTotal Paid
1Millennium Health Llc

San Diego, CA · Clinical Medical Laboratory

$2.7M
2Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$1.4M
3Precision Toxicology, Llc

San Diego, CA · Clinical Medical Laboratory

$1.0M
41598135451$773K
5Aegis Sciences Corporation

Nashville, TN · Clinical Medical Laboratory

$611K
6Brightview Llc

Cincinnati, OH · Internal Medicine Addiction Medicine

$599K
71346363306$473K
81215272406$376K
91215914288$295K
101194744185$279K
11Quest Diagnostics Of Pennsylvania, Inc.

Pittsburgh, PA · Clinical Medical Laboratory

$262K
12Labone Of Ohio Inc

Cincinnati, OH · Clinical Medical Laboratory

$260K
13Accu Reference Medical Lab, Llc

Linden, NJ · Clinical Medical Laboratory

$243K
141700844339$242K
15Acutis Diagnostics Inc

Hicksville, NY · Clinical Medical Laboratory

$228K
161982091617$214K
17Dominion Diagnostics, Llc

North Kingstown, RI · Clinical Medical Laboratory

$213K
181841619731$210K
191639778921$160K
201154720662$149K

Showing top 20 of 435 providers billing this code