#1640 of 11K

80355

HCPCS Procedure Code

HCPCS code 80355 is the #1,640 most-billed Medicaid procedure code, with $17.2M in payments across 3.4M claims from 2018–2024. The national median cost per claim is $6.21. Costs vary widely — the 90th percentile is $14.11 per claim, 2.3× the median.

Total Paid

$17.2M

0.00% of all spending

Total Claims

3.4M

Providers

380

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 80355? Based on 327 providers billing this code nationally.

Median

$6.21

Average

$6.84

Std Dev

$6.09

Max

$50.22

Percentile Distribution (Cost per Claim)

p10

$0.56

p25

$2.24

Median

$6.21

p75

$9.75

p90

$14.11

p95

$16.62

p99

$27.10

50% of providers bill between $2.24 and $9.75 per claim for this code.

90% bill between $0.56 and $14.11.

Top 1% bill above $27.10.

About This Procedure

HCPCS code 80355 was billed by 380 providers across 3.4M claims, totaling $17.2M in Medicaid payments from 2018–2024. This code was used for 2.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.21

Providers Billing

327

National Spending

$17.2M

Avg/Median Ratio

1.10×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 80355

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Millennium Health Llc San Diego, CA · Clinical Medical Laboratory	$2.4M	$3.31	0.5× median	Below Median
2	Labone Of Ohio Inc Cincinnati, OH · Clinical Medical Laboratory	$1.8M	$8.61	1.4× median	Above Median
3	Precision Toxicology, Llc San Diego, CA · Clinical Medical Laboratory	$1.1M	$9.36	1.5× median	Above Median
4	Brightview Llc Cincinnati, OH · Internal Medicine Addiction Medicine	$1.0M	$8.24	1.3× median	Above Median
5	1598135451	$871K	$15.37	2.5× median	Top 10%
6	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$833K	$5.52	0.9× median	Below Median
7	Aegis Sciences Corporation Nashville, TN · Clinical Medical Laboratory	$641K	$5.30	0.9× median	Below Median
8	1346363306	$486K	$10.49	1.7× median	Above 75th
9	1215272406	$361K	$11.88	1.9× median	Above 75th
10	Quest Diagnostics Of Pennsylvania, Inc. Pittsburgh, PA · Clinical Medical Laboratory	$359K	$3.44	0.6× median	Below Median
11	Acutis Diagnostics Inc Hicksville, NY · Clinical Medical Laboratory	$261K	$4.19	0.7× median	Below Median
12	1841619731	$246K	$4.78	0.8× median	Below Median
13	1184170136	$236K	$7.18	1.2× median	Above Median
14	1073961108	$209K	$2.95	0.5× median	Below Median
15	1982091617	$193K	$8.35	1.3× median	Above Median
16	1427543586	$178K	$14.91	2.4× median	Top 10%
17	1821092297	$161K	$7.20	1.2× median	Above Median
18	1639778921	$160K	$13.93	2.2× median	Above 75th
19	1194744185	$156K	$2.04	0.3× median	Below Median
20	1700844339	$152K	$7.03	1.1× median	Above Median

Showing top 20 of 380 providers billing this code

Related Procedures

80348$30.7M 80361$27.2M 80346$25.6M 80354$23.2M 80365$21.2M

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