#4379 of 11K

87280

HCPCS Procedure Code

HCPCS code 87280 is the #4,379 most-billed Medicaid procedure code, with $622K in payments across 62K claims from 2018–2024. The national median cost per claim is $7.30. Costs vary widely — the 90th percentile is $17.78 per claim, 2.4× the median.

Total Paid

$622K

0.00% of all spending

Total Claims

62K

Providers

191

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for 87280? Based on 167 providers billing this code nationally.

Median

$7.30

Average

$10.36

Std Dev

$15.40

Max

$122.65

Percentile Distribution (Cost per Claim)

p10

$0.43

p25

$2.25

Median

$7.30

p75

$12.29

p90

$17.78

p95

$28.27

p99

$84.88

50% of providers bill between $2.25 and $12.29 per claim for this code.

90% bill between $0.43 and $17.78.

Top 1% bill above $84.88.

About This Procedure

HCPCS code 87280 was billed by 191 providers across 62K claims, totaling $622K in Medicaid payments from 2018–2024. This code was used for 57K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.30

Providers Billing

167

National Spending

$622K

Avg/Median Ratio

1.42×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87280

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1174500458	$190K	$54.96	7.5× median	Top 10%
2	1942298153	$63K	$16.73	2.3× median	Above 75th
3	1629174248	$33K	$7.87	1.1× median	Above Median
4	1285681908	$21K	$10.21	1.4× median	Above Median
5	1861530750	$21K	$10.53	1.4× median	Above Median
6	Integrated Regional Laboratories Pathology Services Llc Atlantis, FL · Pathology Anatomic Pathology & Clinical Pathology	$19K	$4.00	0.5× median	Below Median
7	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$18K	$7.30	1.0× median	Below Median
8	1134172406	$18K	$10.68	1.5× median	Above Median
9	1245282227	$17K	$122.65	16.8× median	Top 1%
10	1316925506	$14K	$15.07	2.1× median	Above 75th
11	1245294826	$13K	$29.50	4.0× median	Top 10%
12	1104830900	$13K	$20.96	2.9× median	Top 10%
13	1992751879	$12K	$14.08	1.9× median	Above 75th
14	Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory	$10K	$6.54	0.9× median	Below Median
15	1730164435	$8K	$7.74	1.1× median	Above Median
16	1164471116	$8K	$1.90	0.3× median	Below Median
17	1700831724	$7K	$13.90	1.9× median	Above 75th
18	1407887003	$7K	$115.31	15.8× median	Top 1%
19	Quest Diagnostics Massachusetts Llc Marlborough, MA · Clinical Medical Laboratory	$7K	$11.33	1.6× median	Above Median
20	1548370745	$5K	$9.42	1.3× median	Above Median

Showing top 20 of 191 providers billing this code

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