#2596 of 11K

88365

HCPCS Procedure Code

HCPCS code 88365 is the #2,596 most-billed Medicaid procedure code, with $4.7M in payments across 65K claims from 2018–2024. The national median cost per claim is $38.20. Costs vary widely — the 90th percentile is $98.76 per claim, 2.6× the median.

Total Paid

$4.7M

0.00% of all spending

Total Claims

65K

Providers

Avg Cost/Claim

$72

National Cost Distribution

How much do providers bill per claim for 88365? Based on 57 providers billing this code nationally.

Median

$38.20

Average

$55.17

Std Dev

$40.73

Max

$208.62

Percentile Distribution (Cost per Claim)

p10

$14.26

p25

$25.41

Median

$38.20

p75

$82.69

p90

$98.76

p95

$112.65

p99

$187.00

50% of providers bill between $25.41 and $82.69 per claim for this code.

90% bill between $14.26 and $98.76.

Top 1% bill above $187.00.

About This Procedure

HCPCS code 88365 was billed by 63 providers across 65K claims, totaling $4.7M in Medicaid payments from 2018–2024. This code was used for 60K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$38.20

Providers Billing

National Spending

$4.7M

Avg/Median Ratio

1.44×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 88365

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1225016140	$3.5M	$93.28	2.4× median	Above 75th
2	Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory	$201K	$59.68	1.6× median	Above Median
3	Genesis Laboratory Management, Llc Oakhurst, NJ · Clinical Medical Laboratory	$200K	$61.24	1.6× median	Above Median
4	1447437355	$165K	$35.94	0.9× median	Below Median
5	1619972254	$99K	$102.01	2.7× median	Top 10%
6	1013973866	$84K	$37.54	1.0× median	Below Median
7	1235234402	$75K	$37.48	1.0× median	Below Median
8	1770559981	$48K	$16.46	0.4× median	Below Median
9	Permanente Medical Group Inc. Berkeley, CA · Clinical Medical Laboratory	$47K	$208.62	5.5× median	Top 1%
10	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$36K	$96.59	2.5× median	Above 75th
11	1962480608	$32K	$27.67	0.7× median	Below Median
12	1043282841	$27K	$110.16	2.9× median	Top 10%
13	1508890468	$19K	$23.17	0.6× median	Below Median
14	1124536107	$19K	$33.45	0.9× median	Below Median
15	The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital	$17K	$63.21	1.7× median	Above Median
16	1699115857	$14K	$47.87	1.3× median	Above Median
17	1992700124	$13K	$82.69	2.2× median	Above 75th
18	1659672004	$12K	$45.26	1.2× median	Above Median
19	1306151956	$11K	$32.21	0.8× median	Below Median
20	Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital	$11K	$87.69	2.3× median	Above 75th

Showing top 20 of 63 providers billing this code

Related Procedures

88360$13.5M 88374$7.0M 88361$4.4M 88356$4.0M 88364$1.0M

← All procedures Top providers →