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#4003 of 11K

87254

HCPCS Procedure Code

HCPCS code 87254 is the #4,003 most-billed Medicaid procedure code, with $939K in payments across 65K claims from 2018–2024. The national median cost per claim is $9.47. Costs vary widely — the 90th percentile is $22.63 per claim, 2.4× the median.

Total Paid

$939K

0.00% of all spending

Total Claims

65K

Providers

104

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for 87254? Based on 95 providers billing this code nationally.

Median

$9.47

Average

$12.35

Std Dev

$11.11

Max

$72.48

Percentile Distribution (Cost per Claim)

p10
$1.45
p25
$4.97
Median
$9.47
p75
$17.65
p90
$22.63
p95
$32.92
p99
$41.69

50% of providers bill between $4.97 and $17.65 per claim for this code.

90% bill between $1.45 and $22.63.

Top 1% bill above $41.69.

About This Procedure

HCPCS code 87254 was billed by 104 providers across 65K claims, totaling $939K in Medicaid payments from 2018–2024. This code was used for 61K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.47

Providers Billing

95

National Spending

$939K

Avg/Median Ratio

1.30×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87254

#ProviderTotal Paid
1Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$373K
21457393829$66K
3Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$48K
4Quest Diagnostics Llc

Marlborough, MA · Clinical Medical Laboratory

$42K
5Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$32K
61992171433$32K
7Quest Diagnostics Llc Il

Wood Dale, IL · Clinical Medical Laboratory

$27K
81447259627$26K
91174517353$25K
101356528269$24K
11Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$21K
121538345251$17K
13Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$16K
14Quest Diagnostics Clinical Laboratories Inc

Tucker, GA · Clinical Medical Laboratory

$14K
151467487637$14K
16Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$14K
171710916945$12K
18Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$11K
19Laboratory Corporation Of America

Seattle, WA · Clinical Medical Laboratory

$8K
201124130653$7K

Showing top 20 of 104 providers billing this code