88161
HCPCS Procedure Code
HCPCS code 88161 is the #6,387 most-billed Medicaid procedure code, with $70K in payments across 2K claims from 2018–2024. The national median cost per claim is $19.03. Costs vary widely — the 90th percentile is $51.10 per claim, 2.7× the median.
Total Paid
$70K
0.00% of all spending
Total Claims
2K
Providers
12
Avg Cost/Claim
$45
National Cost Distribution
How much do providers bill per claim for 88161? Based on 10 providers billing this code nationally.
Median
$19.03
Average
$28.13
Std Dev
$25.35
Max
$90.10
Percentile Distribution (Cost per Claim)
50% of providers bill between $12.88 and $35.40 per claim for this code.
90% bill between $8.87 and $51.10.
Top 1% bill above $86.20.
About This Procedure
HCPCS code 88161 was billed by 12 providers across 2K claims, totaling $70K in Medicaid payments from 2018–2024. This code was used for 1K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$19.03
Providers Billing
10
National Spending
$70K
Avg/Median Ratio
1.48×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 88161
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1184616740 | $36K |
| 2 | Children's Hospital Corporation Boston, MA · Clinic/Center | $17K |
| 3 | 1538180989 | $12K |
| 4 | 1245390855 | $2K |
| 5 | 1457389033 | $1K |
| 6 | Bronxcare Health System Bronx, NY · General Acute Care Hospital | $708 |
| 7 | 1821095167 | $500 |
| 8 | Laboratory Corporation Of America Holdings Charleston, WV · Clinical Medical Laboratory | $349 |
| 9 | 1780653618 | $255 |
| 10 | Duke Health Integrated Practice, Inc. Durham, NC · General Practice | $177 |
| 11 | 1255669495 | $0 |
| 12 | 1770598534 | $0 |
Showing top 12 of 12 providers billing this code