#1495 of 11K

80365

HCPCS Procedure Code

HCPCS code 80365 is the #1,495 most-billed Medicaid procedure code, with $21.2M in payments across 4.2M claims from 2018–2024. The national median cost per claim is $5.24. Costs vary widely — the 90th percentile is $15.32 per claim, 2.9× the median.

Total Paid

$21.2M

0.00% of all spending

Total Claims

4.2M

Providers

510

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 80365? Based on 433 providers billing this code nationally.

Median

$5.24

Average

$7.60

Std Dev

$10.64

Max

$152.74

Percentile Distribution (Cost per Claim)

p10

$0.60

p25

$2.24

Median

$5.24

p75

$9.79

p90

$15.32

p95

$21.20

p99

$39.61

50% of providers bill between $2.24 and $9.79 per claim for this code.

90% bill between $0.60 and $15.32.

Top 1% bill above $39.61.

About This Procedure

HCPCS code 80365 was billed by 510 providers across 4.2M claims, totaling $21.2M in Medicaid payments from 2018–2024. This code was used for 2.9M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.24

Providers Billing

433

National Spending

$21.2M

Avg/Median Ratio

1.45×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 80365

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Millennium Health Llc San Diego, CA · Clinical Medical Laboratory	$3.5M	$3.60	0.7× median	Below Median
2	Precision Toxicology, Llc San Diego, CA · Clinical Medical Laboratory	$1.5M	$9.47	1.8× median	Above Median
3	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$1.4M	$6.31	1.2× median	Above Median
4	Brightview Llc Cincinnati, OH · Internal Medicine Addiction Medicine	$1.0M	$8.13	1.6× median	Above Median
5	1598135451	$903K	$15.37	2.9× median	Top 10%
6	Aegis Sciences Corporation Nashville, TN · Clinical Medical Laboratory	$672K	$4.68	0.9× median	Below Median
7	1346363306	$493K	$10.45	2.0× median	Above 75th
8	Labone Of Ohio Inc Cincinnati, OH · Clinical Medical Laboratory	$462K	$7.22	1.4× median	Above Median
9	1215272406	$378K	$11.98	2.3× median	Above 75th
10	Ideal Option, Pllc Pasco, WA · Preventive Medicine, Addiction Medicine	$376K	$23.07	4.4× median	Top 10%
11	1194744185	$320K	$3.30	0.6× median	Below Median
12	Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory	$291K	$5.10	1.0× median	Below Median
13	1821092297	$280K	$3.45	0.7× median	Below Median
14	1215914288	$273K	$3.45	0.7× median	Below Median
15	1427543586	$265K	$14.87	2.8× median	Above 75th
16	1144527003	$263K	$8.11	1.5× median	Above Median
17	1700844339	$247K	$6.60	1.3× median	Above Median
18	Acutis Diagnostics Inc Hicksville, NY · Clinical Medical Laboratory	$219K	$3.90	0.7× median	Below Median
19	1982091617	$218K	$8.13	1.6× median	Above Median
20	1184170136	$210K	$6.62	1.3× median	Above Median

Showing top 20 of 510 providers billing this code

Related Procedures

80361$27.2M 80373$21.4M 80358$20.0M 80356Benzodiazepine drug assay by definitive method$17.5M 80355$17.2M

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