#1328 of 11K

80361

HCPCS Procedure Code

HCPCS code 80361 is the #1,328 most-billed Medicaid procedure code, with $27.2M in payments across 4.5M claims from 2018–2024. The national median cost per claim is $7.53. Costs vary widely — the 90th percentile is $18.32 per claim, 2.4× the median.

Total Paid

$27.2M

0.00% of all spending

Total Claims

4.5M

Providers

545

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 80361? Based on 460 providers billing this code nationally.

Median

$7.53

Average

$9.67

Std Dev

$11.23

Max

$132.43

Percentile Distribution (Cost per Claim)

p10

$1.11

p25

$3.06

Median

$7.53

p75

$13.34

p90

$18.32

p95

$23.24

p99

$43.89

50% of providers bill between $3.06 and $13.34 per claim for this code.

90% bill between $1.11 and $18.32.

Top 1% bill above $43.89.

About This Procedure

HCPCS code 80361 was billed by 545 providers across 4.5M claims, totaling $27.2M in Medicaid payments from 2018–2024. This code was used for 3.0M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.53

Providers Billing

460

National Spending

$27.2M

Avg/Median Ratio

1.28×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 80361

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Millennium Health Llc San Diego, CA · Clinical Medical Laboratory	$4.1M	$4.31	0.6× median	Below Median
2	Brightview Llc Cincinnati, OH · Internal Medicine Addiction Medicine	$1.9M	$14.78	2.0× median	Above 75th
3	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$1.9M	$7.92	1.1× median	Above Median
4	Precision Toxicology, Llc San Diego, CA · Clinical Medical Laboratory	$1.5M	$9.81	1.3× median	Above Median
5	Labone Of Ohio Inc Cincinnati, OH · Clinical Medical Laboratory	$937K	$11.73	1.6× median	Above Median
6	1346363306	$893K	$18.51	2.5× median	Top 10%
7	Aegis Sciences Corporation Nashville, TN · Clinical Medical Laboratory	$777K	$5.41	0.7× median	Below Median
8	Ideal Option, Pllc Pasco, WA · Preventive Medicine, Addiction Medicine	$628K	$30.75	4.1× median	Top 10%
9	1700844339	$448K	$11.97	1.6× median	Above Median
10	Dominion Diagnostics, Llc North Kingstown, RI · Clinical Medical Laboratory	$396K	$17.24	2.3× median	Above 75th
11	1184170136	$392K	$12.29	1.6× median	Above Median
12	1215914288	$392K	$4.58	0.6× median	Below Median
13	1215272406	$380K	$11.84	1.6× median	Above Median
14	Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory	$328K	$5.95	0.8× median	Below Median
15	1821092297	$310K	$3.48	0.5× median	Below Median
16	1194744185	$308K	$3.27	0.4× median	Below Median
17	1841619731	$286K	$8.31	1.1× median	Above Median
18	Quest Diagnostics Of Pennsylvania, Inc. Pittsburgh, PA · Clinical Medical Laboratory	$275K	$5.07	0.7× median	Below Median
19	1427543586	$265K	$14.87	2.0× median	Above 75th
20	1154720662	$264K	$22.91	3.0× median	Top 10%

Showing top 20 of 545 providers billing this code

Related Procedures

80354$23.2M 80365$21.2M 80358$20.0M 80353Benzodiazepine drug level, definitive method, each$19.2M 80356Benzodiazepine drug assay by definitive method$17.5M

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