Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1825 of 11K

80320

HCPCS Procedure Code

HCPCS code 80320 is the #1,825 most-billed Medicaid procedure code, with $13.2M in payments across 2.0M claims from 2018–2024. The national median cost per claim is $4.02. Costs vary widely — the 90th percentile is $22.75 per claim, 5.7× the median.

Total Paid

$13.2M

0.00% of all spending

Total Claims

2.0M

Providers

1K

Avg Cost/Claim

$7

National Cost Distribution

How much do providers bill per claim for 80320? Based on 1K providers billing this code nationally.

Median

$4.02

Average

$11.03

Std Dev

$21.78

Max

$233.97

Percentile Distribution (Cost per Claim)

p10
$0.11
p25
$0.71
Median
$4.02
p75
$12.28
p90
$22.75
p95
$46.61
p99
$104.51

50% of providers bill between $0.71 and $12.28 per claim for this code.

90% bill between $0.11 and $22.75.

Top 1% bill above $104.51.

About This Procedure

HCPCS code 80320 was billed by 1K providers across 2.0M claims, totaling $13.2M in Medicaid payments from 2018–2024. This code was used for 1.7M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$4.02

Providers Billing

1K

National Spending

$13.2M

Avg/Median Ratio

2.74×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 80320

#ProviderTotal Paid
11689682999$815K
21669461281$390K
31225195340$344K
41821042979$341K
51659327013$304K
6Accu Reference Medical Lab, Llc

Linden, NJ · Clinical Medical Laboratory

$286K
71932112125$269K
8Charleston Area Medical Center Inc

Charleston, WV · General Acute Care Hospital

$263K
91720004450$250K
10Trinitas Regional Medical Center

Elizabeth, NJ · General Acute Care Hospital

$231K
111689624686$195K
121710951801$183K
13Kennedy University Hospital Inc.

Stratford, NJ · General Acute Care Hospital

$172K
141326296211$138K
151467806646$131K
161598144362$131K
17Saint Peter's University Hospital

New Brunswick, NJ · General Acute Care Hospital

$130K
18Integrated Regional Laboratories Pathology Services Llc

Atlantis, FL · Pathology Anatomic Pathology & Clinical Pathology

$126K
191205860335$123K
20Banner Thunderbird Medical Center

Glendale, AZ · Community/Behavioral Health

$114K

Showing top 20 of 1K providers billing this code