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#6227 of 11K

87542

HCPCS Procedure Code

HCPCS code 87542 is the #6,227 most-billed Medicaid procedure code, with $82K in payments across 8K claims from 2018–2024. The national median cost per claim is $6.71. Costs vary widely — the 90th percentile is $28.68 per claim, 4.3× the median.

Total Paid

$82K

0.00% of all spending

Total Claims

8K

Providers

7

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for 87542? Based on 7 providers billing this code nationally.

Median

$6.71

Average

$12.57

Std Dev

$15.85

Max

$46.00

Percentile Distribution (Cost per Claim)

p10
$1.74
p25
$2.47
Median
$6.71
p75
$14.60
p90
$28.68
p95
$37.34
p99
$44.27

50% of providers bill between $2.47 and $14.60 per claim for this code.

90% bill between $1.74 and $28.68.

Top 1% bill above $44.27.

About This Procedure

HCPCS code 87542 was billed by 7 providers across 8K claims, totaling $82K in Medicaid payments from 2018–2024. This code was used for 7K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.71

Providers Billing

7

National Spending

$82K

Avg/Median Ratio

1.87×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 87542

#ProviderTotal Paid
11568868446$46K
2Medarbor Llc

Bristol, PA · Clinical Medical Laboratory

$18K
31922551399$15K
41073023487$1K
51558808204$837
61376944793$494
71467464917$329

Showing top 7 of 7 providers billing this code