#1447 of 11K

87511

HCPCS Procedure Code

HCPCS code 87511 is the #1,447 most-billed Medicaid procedure code, with $23.0M in payments across 1.5M claims from 2018–2024. The national median cost per claim is $16.46. Costs vary widely — the 90th percentile is $36.43 per claim, 2.2× the median.

Total Paid

$23.0M

0.00% of all spending

Total Claims

1.5M

Providers

447

Avg Cost/Claim

$16

National Cost Distribution

How much do providers bill per claim for 87511? Based on 422 providers billing this code nationally.

Median

$16.46

Average

$18.93

Std Dev

$17.00

Max

$248.89

Percentile Distribution (Cost per Claim)

p10

$2.79

p25

$7.95

Median

$16.46

p75

$26.24

p90

$36.43

p95

$43.51

p99

$50.42

50% of providers bill between $7.95 and $26.24 per claim for this code.

90% bill between $2.79 and $36.43.

Top 1% bill above $50.42.

About This Procedure

HCPCS code 87511 was billed by 447 providers across 1.5M claims, totaling $23.0M in Medicaid payments from 2018–2024. This code was used for 1.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$16.46

Providers Billing

422

National Spending

$23.0M

Avg/Median Ratio

1.15×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87511

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1750373908	$4.2M	$14.52	0.9× median	Below Median
2	Healthtrackrx Indiana, Inc Denton, TX · Clinical Medical Laboratory	$1.6M	$13.25	0.8× median	Below Median
3	Eurofins Diatherix Laboratories Llc Huntsville, AL · Clinical Medical Laboratory	$1.4M	$9.94	0.6× median	Below Median
4	Boston Medical Center Corporation Boston, MA · General Acute Care Hospital	$1.3M	$26.07	1.6× median	Above Median
5	Associated Pathologists, Llc Nashville, TN · Medical Genetics, Clinical Genetics (M.D.)	$1.1M	$16.24	1.0× median	Below Median
6	1326086745	$772K	$30.25	1.8× median	Above 75th
7	Physicians Group Laboratories, Llc Houma, LA · Clinical Medical Laboratory	$556K	$14.21	0.9× median	Below Median
8	The Moses H. Cone Memorial Hospital Operating Corporation Greensboro, NC · General Acute Care Hospital	$488K	$30.70	1.9× median	Above 75th
9	1962481820	$432K	$10.78	0.7× median	Below Median
10	1124075635	$410K	$16.23	1.0× median	Below Median
11	1215946025	$394K	$31.49	1.9× median	Above 75th
12	Sunrise Medical Laboratories, Inc. Hicksville, NY · Clinical Medical Laboratory	$339K	$14.23	0.9× median	Below Median
13	1053721373	$335K	$22.55	1.4× median	Above Median
14	1770529513	$328K	$33.31	2.0× median	Above 75th
15	1063619922	$320K	$10.72	0.7× median	Below Median
16	1548208440	$283K	$17.25	1.0× median	Above Median
17	1174009245	$242K	$7.03	0.4× median	Below Median
18	1053530758	$210K	$17.47	1.1× median	Above Median
19	1649829987	$203K	$28.02	1.7× median	Above 75th
20	1679534069	$191K	$32.18	2.0× median	Above 75th

Showing top 20 of 447 providers billing this code

Related Procedures

87502Influenza virus detection, reverse transcription, amplified probe$444.3M 87507$63.3M 87510$46.9M 87512$29.2M 87517$17.6M

← All procedures Top providers →