#3859 of 11K

88314

HCPCS Procedure Code

HCPCS code 88314 is the #3,859 most-billed Medicaid procedure code, with $1.1M in payments across 20K claims from 2018–2024. The national median cost per claim is $34.10. Costs vary widely — the 90th percentile is $83.47 per claim, 2.4× the median.

Total Paid

$1.1M

0.00% of all spending

Total Claims

20K

Providers

Avg Cost/Claim

$53

National Cost Distribution

How much do providers bill per claim for 88314? Based on 20 providers billing this code nationally.

Median

$34.10

Average

$44.41

Std Dev

$38.82

Max

$155.63

Percentile Distribution (Cost per Claim)

p10

$7.42

p25

$14.53

Median

$34.10

p75

$63.78

p90

$83.47

p95

$97.07

p99

$143.92

50% of providers bill between $14.53 and $63.78 per claim for this code.

90% bill between $7.42 and $83.47.

Top 1% bill above $143.92.

About This Procedure

HCPCS code 88314 was billed by 20 providers across 20K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 18K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$34.10

Providers Billing

National Spending

$1.1M

Avg/Median Ratio

1.30×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 88314

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1447244256	$508K	$57.60	1.7× median	Above Median
2	1861990335	$308K	$58.29	1.7× median	Above Median
3	1952619983	$149K	$82.30	2.4× median	Above 75th
4	1932102027	$19K	$81.05	2.4× median	Above 75th
5	1467433292	$18K	$80.23	2.4× median	Above 75th
6	1053686964	$15K	$31.43	0.9× median	Below Median
7	Medical University Hospital Authority Charleston, SC · General Acute Care Hospital	$15K	$14.90	0.4× median	Below Median
8	1518473263	$13K	$13.43	0.4× median	Below Median
9	1437509858	$10K	$40.20	1.2× median	Above Median
10	1164962882	$8K	$93.99	2.8× median	Top 10%
11	1255828174	$2K	$155.63	4.6× median	Top 1%
12	1962463786	$2K	$33.64	1.0× median	Below Median
13	1932111960	$2K	$3.66	0.1× median	Below Median
14	1649339581	$2K	$34.57	1.0× median	Above Median
15	1730708215	$1K	$44.57	1.3× median	Above Median
16	1437292927	$1K	$25.72	0.8× median	Below Median
17	1821002007	$1K	$19.95	0.6× median	Below Median
18	1215916002	$939	$8.39	0.2× median	Below Median
19	1174698468	$384	$7.84	0.2× median	Below Median
20	1063422053	$85	$0.83	0.0× median	Below Median

Showing top 20 of 20 providers billing this code

Related Procedures

88305Surgical pathology, gross and microscopic examination$1.44B 88307Surgical pathology, gross and microscopic, complex$225.8M 88312$102.8M 88304$64.6M 88313$62.6M

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