#3300 of 11K

88264

HCPCS Procedure Code

HCPCS code 88264 is the #3,300 most-billed Medicaid procedure code, with $2.0M in payments across 37K claims from 2018–2024. The national median cost per claim is $50.67. Costs vary widely — the 90th percentile is $119.79 per claim, 2.4× the median.

Total Paid

$2.0M

0.00% of all spending

Total Claims

37K

Providers

Avg Cost/Claim

$53

National Cost Distribution

How much do providers bill per claim for 88264? Based on 60 providers billing this code nationally.

Median

$50.67

Average

$60.62

Std Dev

$55.39

Max

$361.66

Percentile Distribution (Cost per Claim)

p10

$8.45

p25

$27.39

Median

$50.67

p75

$81.95

p90

$119.79

p95

$130.04

p99

$235.25

50% of providers bill between $27.39 and $81.95 per claim for this code.

90% bill between $8.45 and $119.79.

Top 1% bill above $235.25.

About This Procedure

HCPCS code 88264 was billed by 63 providers across 37K claims, totaling $2.0M in Medicaid payments from 2018–2024. This code was used for 34K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$50.67

Providers Billing

National Spending

$2.0M

Avg/Median Ratio

1.20×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 88264

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1447437355	$399K	$65.49	1.3× median	Above Median
2	1699115857	$204K	$50.15	1.0× median	Below Median
3	1306875877	$148K	$81.84	1.6× median	Above Median
4	Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory	$133K	$94.48	1.9× median	Above 75th
5	1871615708	$119K	$32.22	0.6× median	Below Median
6	1164493847	$99K	$46.89	0.9× median	Below Median
7	1740240753	$86K	$63.05	1.2× median	Above Median
8	1124269717	$83K	$147.40	2.9× median	Top 10%
9	1073549663	$72K	$43.55	0.9× median	Below Median
10	1003245317	$69K	$50.39	1.0× median	Below Median
11	1467433292	$60K	$52.81	1.0× median	Above Median
12	1740460583	$55K	$77.30	1.5× median	Above Median
13	Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital	$50K	$119.66	2.4× median	Above 75th
14	1679580286	$48K	$39.16	0.8× median	Below Median
15	1124536107	$47K	$38.86	0.8× median	Below Median
16	1588712285	$39K	$120.93	2.4× median	Top 10%
17	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$34K	$129.72	2.6× median	Top 10%
18	Froedtert Memorial Lutheran Hospital, Inc. Milwaukee, WI · Clinic/Center, Radiology	$34K	$62.76	1.2× median	Above Median
19	1912307547	$23K	$74.96	1.5× median	Above Median
20	Mayo Collaborative Services, Inc Rochester, MN · Clinical Medical Laboratory	$22K	$49.76	1.0× median	Below Median

Showing top 20 of 63 providers billing this code

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