#5809 of 11K

87305

HCPCS Procedure Code

HCPCS code 87305 is the #5,809 most-billed Medicaid procedure code, with $135K in payments across 21K claims from 2018–2024. The national median cost per claim is $5.41. Costs vary widely — the 90th percentile is $14.82 per claim, 2.7× the median.

Total Paid

$135K

0.00% of all spending

Total Claims

21K

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 87305? Based on 37 providers billing this code nationally.

Median

$5.41

Average

$6.46

Std Dev

$5.77

Max

$26.58

Percentile Distribution (Cost per Claim)

p10

$1.03

p25

$2.24

Median

$5.41

p75

$8.60

p90

$14.82

p95

$16.44

p99

$23.25

50% of providers bill between $2.24 and $8.60 per claim for this code.

90% bill between $1.03 and $14.82.

Top 1% bill above $23.25.

About This Procedure

HCPCS code 87305 was billed by 38 providers across 21K claims, totaling $135K in Medicaid payments from 2018–2024. This code was used for 13K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.41

Providers Billing

National Spending

$135K

Avg/Median Ratio

1.19×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87305

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1477549756	$26K	$7.30	1.3× median	Above Median
2	1891873303	$26K	$16.22	3.0× median	Top 10%
3	1518917350	$15K	$15.76	2.9× median	Top 10%
4	1053334755	$12K	$5.99	1.1× median	Above Median
5	Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital	$8K	$12.02	2.2× median	Above 75th
6	1376548271	$6K	$10.72	2.0× median	Above 75th
7	1073574810	$5K	$6.60	1.2× median	Above Median
8	1316241102	$5K	$2.24	0.4× median	Below Median
9	University Of Kentucky Lexington, KY · General Acute Care Hospital	$5K	$10.20	1.9× median	Above 75th
10	1699874248	$4K	$2.54	0.5× median	Below Median
11	Regents Of The University Of California San Diego, CA · General Acute Care Hospital	$3K	$6.08	1.1× median	Above Median
12	1073587937	$3K	$8.61	1.6× median	Above 75th
13	Permanente Medical Group, Inc. Richmond, CA · Clinical Medical Laboratory	$3K	$26.58	4.9× median	Top 1%
14	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$3K	$5.70	1.1× median	Above Median
15	Robert Wood Johnson University Hospital, Inc New Brunswick, NJ · General Acute Care Hospital	$1K	$1.88	0.3× median	Below Median
16	Hmh Hospitals Corporation Hackensack, NJ · Ambulance	$1K	$2.79	0.5× median	Below Median
17	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$1K	$4.34	0.8× median	Below Median
18	1316900277	$885	$2.75	0.5× median	Below Median
19	1457354656	$683	$7.85	1.5× median	Above Median
20	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$630	$0.32	0.1× median	Below Median

Showing top 20 of 38 providers billing this code

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