#1947 of 11K

88189

HCPCS Procedure Code

HCPCS code 88189 is the #1,947 most-billed Medicaid procedure code, with $11.1M in payments across 282K claims from 2018–2024. The national median cost per claim is $45.87.

Total Paid

$11.1M

0.00% of all spending

Total Claims

282K

Providers

339

Avg Cost/Claim

$39

National Cost Distribution

How much do providers bill per claim for 88189? Based on 338 providers billing this code nationally.

Median

$45.87

Average

$47.09

Std Dev

$22.10

Max

$133.31

Percentile Distribution (Cost per Claim)

p10

$20.71

p25

$31.98

Median

$45.87

p75

$59.42

p90

$75.54

p95

$85.35

p99

$111.97

50% of providers bill between $31.98 and $59.42 per claim for this code.

90% bill between $20.71 and $75.54.

Top 1% bill above $111.97.

About This Procedure

HCPCS code 88189 was billed by 339 providers across 282K claims, totaling $11.1M in Medicaid payments from 2018–2024. This code was used for 256K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$45.87

Providers Billing

338

National Spending

$11.1M

Avg/Median Ratio

1.03×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 88189

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1396794574	$923K	$58.99	1.3× median	Above Median
2	1447437355	$440K	$31.36	0.7× median	Below Median
3	Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory	$414K	$25.04	0.5× median	Below Median
4	1174503999	$371K	$62.99	1.4× median	Above 75th
5	1740460583	$363K	$80.76	1.8× median	Top 10%
6	1871615708	$349K	$27.41	0.6× median	Below Median
7	Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory	$257K	$40.68	0.9× median	Below Median
8	Yale University New Haven, CT · Internal Medicine	$221K	$41.58	0.9× median	Below Median
9	1083713820	$214K	$52.10	1.1× median	Above Median
10	1356377576	$192K	$64.21	1.4× median	Above 75th
11	1699115857	$188K	$33.95	0.7× median	Below Median
12	1164512851	$181K	$114.81	2.5× median	Top 1%
13	Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory	$174K	$33.51	0.7× median	Below Median
14	1043275787	$170K	$66.26	1.4× median	Above 75th
15	1740240753	$166K	$23.45	0.5× median	Below Median
16	1467433292	$157K	$32.30	0.7× median	Below Median
17	1063464477	$146K	$37.36	0.8× median	Below Median
18	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$141K	$37.98	0.8× median	Below Median
19	1871886366	$140K	$58.59	1.3× median	Above Median
20	William Beaumont Hospital Royal Oak, MI · Internal Medicine, Cardiovascular Disease	$130K	$46.48	1.0× median	Above Median

Showing top 20 of 339 providers billing this code

Related Procedures

88185$63.2M 88184$14.8M 88182$3.1M 88187$2.4M 88188$801K

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