#973 of 11K

87653

HCPCS Procedure Code

HCPCS code 87653 is the #973 most-billed Medicaid procedure code, with $52.3M in payments across 3.0M claims from 2018–2024. The national median cost per claim is $19.33. Costs vary widely — the 90th percentile is $40.58 per claim, 2.1× the median.

Total Paid

$52.3M

0.00% of all spending

Total Claims

3.0M

Providers

Avg Cost/Claim

$17

National Cost Distribution

How much do providers bill per claim for 87653? Based on 1K providers billing this code nationally.

Median

$19.33

Average

$21.21

Std Dev

$20.93

Max

$470.85

Percentile Distribution (Cost per Claim)

p10

$1.68

p25

$8.01

Median

$19.33

p75

$30.57

p90

$40.58

p95

$45.72

p99

$76.45

50% of providers bill between $8.01 and $30.57 per claim for this code.

90% bill between $1.68 and $40.58.

Top 1% bill above $76.45.

About This Procedure

HCPCS code 87653 was billed by 1K providers across 3.0M claims, totaling $52.3M in Medicaid payments from 2018–2024. This code was used for 2.7M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$19.33

Providers Billing

National Spending

$52.3M

Avg/Median Ratio

1.10×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87653

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Physicians Group Laboratories, Llc Houma, LA · Clinical Medical Laboratory	$7.9M	$23.80	1.2× median	Above Median
2	Healthtrackrx Indiana, Inc Denton, TX · Clinical Medical Laboratory	$5.4M	$14.09	0.7× median	Below Median
3	1750373908	$2.9M	$14.48	0.7× median	Below Median
4	Associated Pathologists, Llc Nashville, TN · Medical Genetics, Clinical Genetics (M.D.)	$962K	$16.94	0.9× median	Below Median
5	1174009245	$796K	$9.04	0.5× median	Below Median
6	1124075635	$795K	$21.50	1.1× median	Above Median
7	Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory	$711K	$14.98	0.8× median	Below Median
8	1780059717	$711K	$34.07	1.8× median	Above 75th
9	1801826680	$571K	$31.15	1.6× median	Above 75th
10	Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory	$565K	$12.91	0.7× median	Below Median
11	1649829987	$520K	$29.88	1.5× median	Above Median
12	1326086745	$459K	$31.98	1.7× median	Above 75th
13	1548208440	$458K	$29.74	1.5× median	Above Median
14	1861900698	$420K	$19.36	1.0× median	Above Median
15	1881697464	$416K	$31.97	1.7× median	Above 75th
16	1215930987	$392K	$39.00	2.0× median	Above 75th
17	1467066860	$385K	$11.97	0.6× median	Below Median
18	1245382753	$355K	$71.57	3.7× median	Top 10%
19	1710916945	$349K	$23.85	1.2× median	Above Median
20	1225316482	$342K	$44.16	2.3× median	Top 10%

Showing top 20 of 1K providers billing this code

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