#1261 of 11K

87640

HCPCS Procedure Code

HCPCS code 87640 is the #1,261 most-billed Medicaid procedure code, with $30.5M in payments across 2.2M claims from 2018–2024. The national median cost per claim is $8.39. Costs vary widely — the 90th percentile is $26.01 per claim, 3.1× the median.

Total Paid

$30.5M

0.00% of all spending

Total Claims

2.2M

Providers

831

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for 87640? Based on 764 providers billing this code nationally.

Median

$8.39

Average

$11.73

Std Dev

$11.41

Max

$72.21

Percentile Distribution (Cost per Claim)

p10

$0.67

p25

$2.66

Median

$8.39

p75

$18.05

p90

$26.01

p95

$31.94

p99

$57.55

50% of providers bill between $2.66 and $18.05 per claim for this code.

90% bill between $0.67 and $26.01.

Top 1% bill above $57.55.

About This Procedure

HCPCS code 87640 was billed by 831 providers across 2.2M claims, totaling $30.5M in Medicaid payments from 2018–2024. This code was used for 1.9M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$8.39

Providers Billing

764

National Spending

$30.5M

Avg/Median Ratio

1.40×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87640

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Physicians Group Laboratories, Llc Houma, LA · Clinical Medical Laboratory	$7.9M	$23.93	2.9× median	Above 75th
2	Healthtrackrx Indiana, Inc Denton, TX · Clinical Medical Laboratory	$5.0M	$14.53	1.7× median	Above Median
3	1649829987	$1.4M	$30.83	3.7× median	Top 10%
4	1750373908	$1.1M	$13.20	1.6× median	Above Median
5	1053721373	$804K	$19.06	2.3× median	Above 75th
6	1598266421	$707K	$12.41	1.5× median	Above Median
7	Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory	$587K	$13.69	1.6× median	Above Median
8	1033239413	$536K	$16.76	2.0× median	Above Median
9	1861900698	$520K	$18.95	2.3× median	Above 75th
10	1174009245	$398K	$5.16	0.6× median	Below Median
11	1467066860	$383K	$12.01	1.4× median	Above Median
12	1225316482	$365K	$28.21	3.4× median	Top 10%
13	1396794574	$296K	$22.74	2.7× median	Above 75th
14	1326484569	$212K	$12.28	1.5× median	Above Median
15	1528817459	$204K	$20.18	2.4× median	Above 75th
16	1164857512	$201K	$21.47	2.6× median	Above 75th
17	Medarbor Llc Bristol, PA · Clinical Medical Laboratory	$191K	$6.41	0.8× median	Below Median
18	Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory	$185K	$15.18	1.8× median	Above Median
19	1720409154	$183K	$5.29	0.6× median	Below Median
20	Acutis Diagnostics Inc Hicksville, NY · Clinical Medical Laboratory	$180K	$8.04	1.0× median	Below Median

Showing top 20 of 831 providers billing this code

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