87205
HCPCS Procedure Code
HCPCS code 87205 is the #1,897 most-billed Medicaid procedure code, with $12.0M in payments across 5.0M claims from 2018–2024. The national median cost per claim is $2.10. Costs vary widely — the 90th percentile is $5.12 per claim, 2.4× the median.
Total Paid
$12.0M
0.00% of all spending
Total Claims
5.0M
Providers
3K
Avg Cost/Claim
$2
National Cost Distribution
How much do providers bill per claim for 87205? Based on 2K providers billing this code nationally.
Median
$2.10
Average
$3.24
Std Dev
$7.24
Max
$246.18
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.81 and $3.56 per claim for this code.
90% bill between $0.27 and $5.12.
Top 1% bill above $26.88.
About This Procedure
HCPCS code 87205 was billed by 3K providers across 5.0M claims, totaling $12.0M in Medicaid payments from 2018–2024. This code was used for 4.3M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$2.10
Providers Billing
2K
National Spending
$12.0M
Avg/Median Ratio
1.54×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 87205
| # | Provider | Total Paid |
|---|---|---|
| 1 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $225K |
| 2 | Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital | $208K |
| 3 | Multicare Health System Tacoma, WA · Community/Behavioral Health | $202K |
| 4 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $128K |
| 5 | The Miriam Hospital Providence, RI · General Acute Care Hospital | $123K |
| 6 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $115K |
| 7 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $92K |
| 8 | 1912975228 | $84K |
| 9 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $83K |
| 10 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $83K |
| 11 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $82K |
| 12 | A2cl Services, Llc West Allis, WI · Clinical Medical Laboratory | $82K |
| 13 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $82K |
| 14 | 1619980430 | $82K |
| 15 | Summa Health System Akron, OH · General Acute Care Hospital | $81K |
| 16 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $77K |
| 17 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $75K |
| 18 | 1699756221 | $72K |
| 19 | 1053334755 | $72K |
| 20 | Laboratory Corporation Of America Seattle, WA · Clinical Medical Laboratory | $71K |
Showing top 20 of 3K providers billing this code