87040
HCPCS Procedure Code
HCPCS code 87040 is the #880 most-billed Medicaid procedure code, with $63.6M in payments across 9.6M claims from 2018–2024. The national median cost per claim is $5.54. Costs vary widely — the 90th percentile is $15.72 per claim, 2.8× the median.
Total Paid
$63.6M
0.01% of all spending
Total Claims
9.6M
Providers
3,568
Avg Cost/Claim
$7
National Cost Distribution
How much do providers bill per claim for 87040? Based on 3,379 providers billing this code nationally.
Median
$5.54
Average
$8.87
Std Dev
$24.30
Max
$1,044.62
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.69 and $10.15 per claim for this code.
90% bill between $0.37 and $15.72.
Top 1% bill above $70.16.
About This Procedure
HCPCS code 87040 was billed by 3,568 providers across 9.6M claims, totaling $63.6M in Medicaid payments from 2018–2024. This code was used for 6.6M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$5.54
Providers Billing
3,379
National Spending
$63.6M
Avg/Median Ratio
1.60×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 87040
| # | Provider | Total Paid |
|---|---|---|
| 1 | Integrated Regional Laboratories Pathology Services Llc Atlantis, FL · Pathology Anatomic Pathology & Clinical Pathology | $951K |
| 2 | Grossmont Hospital Corporation La Mesa, CA · General Acute Care Hospital | $505K |
| 3 | Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital | $471K |
| 4 | Sharp Chula Vista Medical Center Chula Vista, CA · General Acute Care Hospital | $463K |
| 5 | Sharp Memorial Hospital San Diego, CA · General Acute Care Hospital, Women | $453K |
| 6 | 1609869916 | $410K |
| 7 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $402K |
| 8 | 1306842521 | $363K |
| 9 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $360K |
| 10 | 1457354656 | $353K |
| 11 | 1811946734 | $334K |
| 12 | 1700831724 | $279K |
| 13 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $272K |
| 14 | Arrowhead Regional Medical Center Colton, CA · General Acute Care Hospital | $263K |
| 15 | 1750332565 | $263K |
| 16 | 1922008150 | $262K |
| 17 | Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital | $241K |
| 18 | 1518018191 | $238K |
| 19 | 1043778319 | $232K |
| 20 | 1639135221 | $230K |
Showing top 20 of 3,568 providers billing this code