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#6490 of 11K

87451

HCPCS Procedure Code

HCPCS code 87451 is the #6,490 most-billed Medicaid procedure code, with $61K in payments across 23K claims from 2018–2024. The national median cost per claim is $3.81. Costs vary widely — the 90th percentile is $16.12 per claim, 4.2× the median.

Total Paid

$61K

0.00% of all spending

Total Claims

23K

Providers

11

Avg Cost/Claim

$3

National Cost Distribution

How much do providers bill per claim for 87451? Based on 8 providers billing this code nationally.

Median

$3.81

Average

$7.23

Std Dev

$9.63

Max

$29.66

Percentile Distribution (Cost per Claim)

p10
$0.91
p25
$1.85
Median
$3.81
p75
$7.39
p90
$16.12
p95
$22.89
p99
$28.31

50% of providers bill between $1.85 and $7.39 per claim for this code.

90% bill between $0.91 and $16.12.

Top 1% bill above $28.31.

About This Procedure

HCPCS code 87451 was billed by 11 providers across 23K claims, totaling $61K in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3.81

Providers Billing

8

National Spending

$61K

Avg/Median Ratio

1.90×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 87451

#ProviderTotal Paid
11548370745$34K
21073519443$21K
31912991597$3K
41114081056$2K
51316970932$792
61063422053$454
71487992665$331
81093016651$9
9Niagara Falls Memorial Medical Center

Niagara Falls, NY · General Acute Care Hospital

$0
101366473183$0
11Physicians Group Laboratories, Llc

Houma, LA · Clinical Medical Laboratory

$0

Showing top 11 of 11 providers billing this code

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