#3807 of 11K

88309

HCPCS Procedure Code

HCPCS code 88309 is the #3,807 most-billed Medicaid procedure code, with $1.1M in payments across 10K claims from 2018–2024. The national median cost per claim is $86.67. Costs vary widely — the 90th percentile is $202.16 per claim, 2.3× the median.

Total Paid

$1.1M

0.00% of all spending

Total Claims

10K

Providers

Avg Cost/Claim

$113

National Cost Distribution

How much do providers bill per claim for 88309? Based on 47 providers billing this code nationally.

Median

$86.67

Average

$103.37

Std Dev

$80.61

Max

$362.23

Percentile Distribution (Cost per Claim)

p10

$34.25

p25

$52.48

Median

$86.67

p75

$115.18

p90

$202.16

p95

$282.08

p99

$354.15

50% of providers bill between $52.48 and $115.18 per claim for this code.

90% bill between $34.25 and $202.16.

Top 1% bill above $354.15.

About This Procedure

HCPCS code 88309 was billed by 52 providers across 10K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 9,514 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$86.67

Providers Billing

National Spending

$1.1M

Avg/Median Ratio

1.19×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 88309

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1134119233	$215K	$362.23	4.2× median	Top 1%
2	1508890468	$158K	$86.67	1.0× median	Above Median
3	1467786467	$125K	$275.37	3.2× median	Top 10%
4	1336223635	$74K	$88.40	1.0× median	Above Median
5	1033193875	$62K	$85.98	1.0× median	Below Median
6	William Beaumont Hospital Royal Oak, MI · Internal Medicine, Cardiovascular Disease	$60K	$92.52	1.1× median	Above Median
7	1447299797	$54K	$87.01	1.0× median	Above Median
8	1285682799	$50K	$83.56	1.0× median	Below Median
9	University Of Kentucky Lexington, KY · General Acute Care Hospital	$48K	$119.92	1.4× median	Above 75th
10	1740460583	$41K	$344.68	4.0× median	Top 10%
11	1407060411	$36K	$125.34	1.4× median	Above 75th
12	1568570471	$34K	$87.02	1.0× median	Above Median
13	West Virginia University Medical Corporation Morgantown, WV · Anesthesiology	$33K	$100.68	1.2× median	Above Median
14	University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program	$27K	$139.60	1.6× median	Above 75th
15	Health Network Laboratories, Llc Allentown, PA · Clinical Medical Laboratory	$16K	$44.65	0.5× median	Below Median
16	1437292927	$14K	$105.40	1.2× median	Above Median
17	Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital	$13K	$159.05	1.8× median	Above 75th
18	1558311811	$12K	$145.25	1.7× median	Above 75th
19	1497732630	$10K	$140.17	1.6× median	Above 75th
20	1316984388	$6K	$44.38	0.5× median	Below Median

Showing top 20 of 52 providers billing this code

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