#2073 of 11K

80369

HCPCS Procedure Code

HCPCS code 80369 is the #2,073 most-billed Medicaid procedure code, with $9.4M in payments across 1.6M claims from 2018–2024. The national median cost per claim is $5.73. Costs vary widely — the 90th percentile is $15.91 per claim, 2.8× the median.

Total Paid

$9.4M

0.00% of all spending

Total Claims

1.6M

Providers

276

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 80369? Based on 236 providers billing this code nationally.

Median

$5.73

Average

$7.42

Std Dev

$6.88

Max

$52.50

Percentile Distribution (Cost per Claim)

p10

$0.75

p25

$2.44

Median

$5.73

p75

$10.53

p90

$15.91

p95

$17.46

p99

$33.03

50% of providers bill between $2.44 and $10.53 per claim for this code.

90% bill between $0.75 and $15.91.

Top 1% bill above $33.03.

About This Procedure

HCPCS code 80369 was billed by 276 providers across 1.6M claims, totaling $9.4M in Medicaid payments from 2018–2024. This code was used for 998K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.73

Providers Billing

236

National Spending

$9.4M

Avg/Median Ratio

1.29×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 80369

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Millennium Health Llc San Diego, CA · Clinical Medical Laboratory	$2.3M	$4.09	0.7× median	Below Median
2	Aegis Sciences Corporation Nashville, TN · Clinical Medical Laboratory	$636K	$5.81	1.0× median	Above Median
3	Labone Of Ohio Inc Cincinnati, OH · Clinical Medical Laboratory	$580K	$8.63	1.5× median	Above Median
4	Brightview Llc Cincinnati, OH · Internal Medicine Addiction Medicine	$538K	$8.34	1.5× median	Above Median
5	1841619731	$420K	$8.16	1.4× median	Above Median
6	Precision Toxicology, Llc San Diego, CA · Clinical Medical Laboratory	$404K	$9.71	1.7× median	Above Median
7	Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory	$377K	$7.25	1.3× median	Above Median
8	1215272406	$329K	$12.16	2.1× median	Above 75th
9	1073961108	$250K	$3.33	0.6× median	Below Median
10	1144527003	$175K	$5.40	0.9× median	Below Median
11	1518950732	$155K	$10.05	1.8× median	Above Median
12	1316370950	$135K	$11.89	2.1× median	Above 75th
13	1093136418	$129K	$6.35	1.1× median	Above Median
14	1972888139	$117K	$5.33	0.9× median	Below Median
15	1043271539	$105K	$13.48	2.4× median	Above 75th
16	1003257650	$102K	$16.02	2.8× median	Top 10%
17	Quest Diagnostics Of Pennsylvania, Inc. Pittsburgh, PA · Clinical Medical Laboratory	$98K	$3.03	0.5× median	Below Median
18	1952777831	$94K	$16.39	2.9× median	Top 10%
19	1285256818	$91K	$15.82	2.8× median	Above 75th
20	1922358126	$87K	$7.26	1.3× median	Above Median

Showing top 20 of 276 providers billing this code

Related Procedures

80361$27.2M 80373$21.4M 80365$21.2M 80359$16.0M 80372$15.1M

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