87260
HCPCS Procedure Code
HCPCS code 87260 is the #5,799 most-billed Medicaid procedure code, with $136K in payments across 11K claims from 2018–2024. The national median cost per claim is $6.78. Costs vary widely — the 90th percentile is $18.79 per claim, 2.8× the median.
Total Paid
$136K
0.00% of all spending
Total Claims
11K
Providers
40
Avg Cost/Claim
$12
National Cost Distribution
How much do providers bill per claim for 87260? Based on 34 providers billing this code nationally.
Median
$6.78
Average
$12.75
Std Dev
$27.24
Max
$159.95
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.39 and $12.39 per claim for this code.
90% bill between $0.61 and $18.79.
Top 1% bill above $119.14.
About This Procedure
HCPCS code 87260 was billed by 40 providers across 11K claims, totaling $136K in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$6.78
Providers Billing
34
National Spending
$136K
Avg/Median Ratio
1.88×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 87260
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1073567608 | $62K |
| 2 | 1760567085 | $28K |
| 3 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $20K |
| 4 | 1437141181 | $6K |
| 5 | 1316925506 | $4K |
| 6 | 1790711927 | $3K |
| 7 | 1396731105 | $3K |
| 8 | 1811571417 | $2K |
| 9 | 1548208440 | $864 |
| 10 | 1285805119 | $833 |
| 11 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $673 |
| 12 | 1699858373 | $652 |
| 13 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $620 |
| 14 | 1811080526 | $564 |
| 15 | 1154485944 | $533 |
| 16 | 1477500015 | $400 |
| 17 | 1841242542 | $355 |
| 18 | 1457341851 | $293 |
| 19 | 1235234402 | $200 |
| 20 | 1427181882 | $171 |
Showing top 20 of 40 providers billing this code