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#4808 of 11K

87469

HCPCS Procedure Code

HCPCS code 87469 is the #4,808 most-billed Medicaid procedure code, with $391K in payments across 30K claims from 2018–2024. The national median cost per claim is $17.00.

Total Paid

$391K

0.00% of all spending

Total Claims

30K

Providers

104

Avg Cost/Claim

$13

National Cost Distribution

How much do providers bill per claim for 87469? Based on 95 providers billing this code nationally.

Median

$17.00

Average

$15.99

Std Dev

$13.68

Max

$84.69

Percentile Distribution (Cost per Claim)

p10
$1.22
p25
$5.30
Median
$17.00
p75
$21.11
p90
$28.03
p95
$35.32
p99
$66.93

50% of providers bill between $5.30 and $21.11 per claim for this code.

90% bill between $1.22 and $28.03.

Top 1% bill above $66.93.

About This Procedure

HCPCS code 87469 was billed by 104 providers across 30K claims, totaling $391K in Medicaid payments from 2018–2024. This code was used for 29K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$17.00

Providers Billing

95

National Spending

$391K

Avg/Median Ratio

0.94×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87469

#ProviderTotal Paid
1Quest Diagnostics Massachusetts Llc

Marlborough, MA · Clinical Medical Laboratory

$95K
2Southcoast Hospitals Group, Inc

New Bedford, MA · General Acute Care Hospital

$25K
3Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$18K
4Quest Diagnostics Llc

Marlborough, MA · Clinical Medical Laboratory

$16K
51861404121$16K
61306871223$15K
71962422733$15K
8Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$12K
9Sunrise Medical Laboratories, Inc.

Hicksville, NY · Clinical Medical Laboratory

$11K
10Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$11K
111922024835$10K
121871606764$10K
13Stamford Hospital

Stamford, CT · Hospitalist

$9K
141376548271$7K
15Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$7K
16Quest Diagnostics Of Pennsylvania, Inc.

Pittsburgh, PA · Clinical Medical Laboratory

$7K
171891740585$6K
18Mary Imogene Bassett Hospital

Cooperstown, NY · General Acute Care Hospital, Rural

$6K
191568548782$6K
201982645305$5K

Showing top 20 of 104 providers billing this code