#3935 of 11K

88364

HCPCS Procedure Code

HCPCS code 88364 is the #3,935 most-billed Medicaid procedure code, with $1.0M in payments across 13K claims from 2018–2024. The national median cost per claim is $43.89. Costs vary widely — the 90th percentile is $130.75 per claim, 3.0× the median.

Total Paid

$1.0M

0.00% of all spending

Total Claims

13K

Providers

Avg Cost/Claim

$76

National Cost Distribution

How much do providers bill per claim for 88364? Based on 23 providers billing this code nationally.

Median

$43.89

Average

$55.25

Std Dev

$54.04

Max

$202.95

Percentile Distribution (Cost per Claim)

p10

$4.30

p25

$22.42

Median

$43.89

p75

$67.83

p90

$130.75

p95

$178.30

p99

$198.40

50% of providers bill between $22.42 and $67.83 per claim for this code.

90% bill between $4.30 and $130.75.

Top 1% bill above $198.40.

About This Procedure

HCPCS code 88364 was billed by 26 providers across 13K claims, totaling $1.0M in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$43.89

Providers Billing

National Spending

$1.0M

Avg/Median Ratio

1.26×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 88364

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Genesis Laboratory Management, Llc Oakhurst, NJ · Clinical Medical Laboratory	$595K	$182.27	4.2× median	Top 10%
2	1770559981	$142K	$48.68	1.1× median	Above Median
3	1447437355	$125K	$43.89	1.0× median	Above Median
4	1962480608	$26K	$25.73	0.6× median	Below Median
5	1043282841	$22K	$68.63	1.6× median	Above 75th
6	1619972254	$22K	$70.31	1.6× median	Above 75th
7	1124536107	$13K	$52.19	1.2× median	Above Median
8	Permanente Medical Group Inc. Berkeley, CA · Clinical Medical Laboratory	$13K	$202.95	4.6× median	Top 1%
9	1659672004	$10K	$55.64	1.3× median	Above Median
10	1699115857	$8K	$57.86	1.3× median	Above Median
11	The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital	$7K	$67.04	1.5× median	Above Median
12	Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory	$5K	$37.02	0.8× median	Below Median
13	1467433292	$4K	$25.62	0.6× median	Below Median
14	1396408829	$2K	$19.22	0.4× median	Below Median
15	1992356521	$2K	$142.63	3.2× median	Top 10%
16	1073549663	$2K	$34.87	0.8× median	Below Median
17	Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital	$2K	$10.02	0.2× median	Below Median
18	1740240753	$1K	$8.27	0.2× median	Below Median
19	1790776334	$1K	$2.81	0.1× median	Below Median
20	1205834769	$999	$83.26	1.9× median	Above 75th

Showing top 20 of 26 providers billing this code

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88360$13.5M 88374$7.0M 88365$4.7M 88361$4.4M 88356$4.0M

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