#2125 of 11K

80363

HCPCS Procedure Code

HCPCS code 80363 is the #2,125 most-billed Medicaid procedure code, with $8.7M in payments across 1.3M claims from 2018–2024. The national median cost per claim is $7.61. Costs vary widely — the 90th percentile is $18.25 per claim, 2.4× the median.

Total Paid

$8.7M

0.00% of all spending

Total Claims

1.3M

Providers

175

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 80363? Based on 141 providers billing this code nationally.

Median

$7.61

Average

$9.89

Std Dev

$10.96

Max

$89.75

Percentile Distribution (Cost per Claim)

p10

$1.02

p25

$2.94

Median

$7.61

p75

$14.42

p90

$18.25

p95

$21.02

p99

$49.73

50% of providers bill between $2.94 and $14.42 per claim for this code.

90% bill between $1.02 and $18.25.

Top 1% bill above $49.73.

About This Procedure

HCPCS code 80363 was billed by 175 providers across 1.3M claims, totaling $8.7M in Medicaid payments from 2018–2024. This code was used for 776K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.61

Providers Billing

141

National Spending

$8.7M

Avg/Median Ratio

1.30×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 80363

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Millennium Health Llc San Diego, CA · Clinical Medical Laboratory	$1.9M	$4.11	0.5× median	Below Median
2	Brightview Llc Cincinnati, OH · Internal Medicine Addiction Medicine	$977K	$14.95	2.0× median	Above 75th
3	1467806646	$892K	$15.01	2.0× median	Above 75th
4	1346363306	$757K	$18.95	2.5× median	Top 10%
5	Precision Toxicology, Llc San Diego, CA · Clinical Medical Laboratory	$486K	$9.53	1.3× median	Above Median
6	1700844339	$369K	$11.72	1.5× median	Above Median
7	1841619731	$317K	$6.20	0.8× median	Below Median
8	Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory	$296K	$6.50	0.9× median	Below Median
9	Acutis Diagnostics Inc Hicksville, NY · Clinical Medical Laboratory	$221K	$3.88	0.5× median	Below Median
10	1154720662	$190K	$16.58	2.2× median	Above 75th
11	Aegis Sciences Corporation Nashville, TN · Clinical Medical Laboratory	$139K	$8.65	1.1× median	Above Median
12	1073961108	$134K	$1.45	0.2× median	Below Median
13	1952790206	$113K	$9.23	1.2× median	Above Median
14	1952777831	$108K	$13.40	1.8× median	Above Median
15	Premier Biotech Labs Llc Minneapolis, MN · Clinical Medical Laboratory	$100K	$41.12	5.4× median	Top 10%
16	1114462215	$99K	$13.55	1.8× median	Above Median
17	1790370583	$89K	$16.73	2.2× median	Above 75th
18	1972549855	$68K	$11.90	1.6× median	Above Median
19	1588034219	$64K	$13.06	1.7× median	Above Median
20	1477781425	$60K	$5.90	0.8× median	Below Median

Showing top 20 of 175 providers billing this code

Related Procedures

80361$27.2M 80354$23.2M 80373$21.4M 80365$21.2M 80358$20.0M

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