#2189 of 11K

88120

HCPCS Procedure Code

HCPCS code 88120 is the #2,189 most-billed Medicaid procedure code, with $8.1M in payments across 49K claims from 2018–2024. The national median cost per claim is $122.39. Costs vary widely — the 90th percentile is $366.30 per claim, 3.0× the median.

Total Paid

$8.1M

0.00% of all spending

Total Claims

49K

Providers

Avg Cost/Claim

$164

National Cost Distribution

How much do providers bill per claim for 88120? Based on 59 providers billing this code nationally.

Median

$122.39

Average

$171.60

Std Dev

$139.55

Max

$599.63

Percentile Distribution (Cost per Claim)

p10

$44.45

p25

$77.96

Median

$122.39

p75

$227.77

p90

$366.30

p95

$475.56

p99

$552.69

50% of providers bill between $77.96 and $227.77 per claim for this code.

90% bill between $44.45 and $366.30.

Top 1% bill above $552.69.

About This Procedure

HCPCS code 88120 was billed by 64 providers across 49K claims, totaling $8.1M in Medicaid payments from 2018–2024. This code was used for 45K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$122.39

Providers Billing

National Spending

$8.1M

Avg/Median Ratio

1.40×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 88120

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1154430148	$1.6M	$352.12	2.9× median	Above 75th
2	1740546316	$1.3M	$164.07	1.3× median	Above Median
3	1124049671	$936K	$287.08	2.3× median	Above 75th
4	1396794574	$877K	$346.67	2.8× median	Above 75th
5	1962480608	$448K	$78.92	0.6× median	Below Median
6	Empire City Laboratories, Inc Brooklyn, NY · Clinical Medical Laboratory	$382K	$154.30	1.3× median	Above Median
7	1902018161	$263K	$504.41	4.1× median	Top 10%
8	1427022649	$230K	$423.02	3.5× median	Top 10%
9	1780772061	$199K	$518.69	4.2× median	Top 10%
10	1558808204	$172K	$66.19	0.5× median	Below Median
11	1942254347	$151K	$83.64	0.7× median	Below Median
12	1003141573	$128K	$122.39	1.0× median	Above Median
13	1912997354	$125K	$79.85	0.7× median	Below Median
14	Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory	$120K	$171.92	1.4× median	Above Median
15	1659655124	$112K	$104.33	0.9× median	Below Median
16	1215921549	$110K	$169.60	1.4× median	Above Median
17	1356569388	$90K	$92.29	0.8× median	Below Median
18	1376645135	$83K	$94.38	0.8× median	Below Median
19	1326222696	$73K	$455.73	3.7× median	Top 10%
20	1194971085	$68K	$90.57	0.7× median	Below Median

Showing top 20 of 64 providers billing this code

Related Procedures

88112$24.4M 88121$2.1M

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