#4537 of 11K

88323

HCPCS Procedure Code

HCPCS code 88323 is the #4,537 most-billed Medicaid procedure code, with $526K in payments across 14K claims from 2018–2024. The national median cost per claim is $36.33. Costs vary widely — the 90th percentile is $86.57 per claim, 2.4× the median.

Total Paid

$526K

0.00% of all spending

Total Claims

14K

Providers

Avg Cost/Claim

$39

National Cost Distribution

How much do providers bill per claim for 88323? Based on 35 providers billing this code nationally.

Median

$36.33

Average

$46.35

Std Dev

$29.16

Max

$129.38

Percentile Distribution (Cost per Claim)

p10

$18.98

p25

$28.89

Median

$36.33

p75

$56.85

p90

$86.57

p95

$97.97

p99

$126.64

50% of providers bill between $28.89 and $56.85 per claim for this code.

90% bill between $18.98 and $86.57.

Top 1% bill above $126.64.

About This Procedure

HCPCS code 88323 was billed by 37 providers across 14K claims, totaling $526K in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$36.33

Providers Billing

National Spending

$526K

Avg/Median Ratio

1.28×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 88323

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1447437355	$159K	$32.95	0.9× median	Below Median
2	Mayo Collaborative Services, Inc Rochester, MN · Clinical Medical Laboratory	$95K	$46.88	1.3× median	Above Median
3	1124536107	$38K	$30.12	0.8× median	Below Median
4	Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory	$33K	$36.33	1.0× median	Above Median
5	1447221726	$26K	$48.92	1.3× median	Above Median
6	1467433292	$22K	$84.55	2.3× median	Above 75th
7	1760574065	$20K	$57.51	1.6× median	Above 75th
8	Stanford Health Care Stanford, CA · General Acute Care Hospital	$19K	$43.50	1.2× median	Above Median
9	1174503999	$15K	$87.91	2.4× median	Top 10%
10	Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital	$14K	$36.55	1.0× median	Above Median
11	City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital	$13K	$129.38	3.6× median	Top 1%
12	1871615708	$10K	$31.56	0.9× median	Below Median
13	1699115857	$6K	$38.85	1.1× median	Above Median
14	1306875877	$6K	$25.63	0.7× median	Below Median
15	Empire City Laboratories, Inc Brooklyn, NY · Clinical Medical Laboratory	$6K	$56.19	1.5× median	Above Median
16	1679580286	$6K	$18.02	0.5× median	Below Median
17	1073549663	$4K	$31.62	0.9× median	Below Median
18	1659672004	$4K	$27.74	0.8× median	Below Median
19	1730708215	$4K	$87.97	2.4× median	Top 10%
20	1902846306	$4K	$121.31	3.3× median	Top 10%

Showing top 20 of 37 providers billing this code

Related Procedures

88313$62.6M 88325$2.1M 88321$1.9M 88331$1.1M 88314$1.1M

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