#2223 of 11K

80364

HCPCS Procedure Code

HCPCS code 80364 is the #2,223 most-billed Medicaid procedure code, with $7.6M in payments across 1.3M claims from 2018–2024. The national median cost per claim is $5.09. Costs vary widely — the 90th percentile is $17.48 per claim, 3.4× the median.

Total Paid

$7.6M

0.00% of all spending

Total Claims

1.3M

Providers

239

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 80364? Based on 203 providers billing this code nationally.

Median

$5.09

Average

$8.09

Std Dev

$9.29

Max

$88.36

Percentile Distribution (Cost per Claim)

p10

$0.55

p25

$1.92

Median

$5.09

p75

$12.38

p90

$17.48

p95

$21.58

p99

$39.34

50% of providers bill between $1.92 and $12.38 per claim for this code.

90% bill between $0.55 and $17.48.

Top 1% bill above $39.34.

About This Procedure

HCPCS code 80364 was billed by 239 providers across 1.3M claims, totaling $7.6M in Medicaid payments from 2018–2024. This code was used for 941K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.09

Providers Billing

203

National Spending

$7.6M

Avg/Median Ratio

1.59×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 80364

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$1.1M	$7.55	1.5× median	Above Median
2	1598135451	$903K	$15.37	3.0× median	Above 75th
3	1194744185	$498K	$5.09	1.0× median	Below Median
4	Aegis Sciences Corporation Nashville, TN · Clinical Medical Laboratory	$366K	$7.24	1.4× median	Above Median
5	1215272406	$359K	$12.72	2.5× median	Above 75th
6	1821092297	$301K	$9.98	2.0× median	Above Median
7	1427543586	$265K	$14.87	2.9× median	Above 75th
8	1912300302	$235K	$4.14	0.8× median	Below Median
9	1568724243	$213K	$11.25	2.2× median	Above Median
10	1982091617	$207K	$9.31	1.8× median	Above Median
11	Sherman Abrams Laboratory Inc Brooklyn, NY · Clinical Medical Laboratory	$169K	$7.79	1.5× median	Above Median
12	Millennium Health Llc San Diego, CA · Clinical Medical Laboratory	$150K	$4.55	0.9× median	Below Median
13	1316370950	$139K	$9.78	1.9× median	Above Median
14	1972888139	$137K	$5.74	1.1× median	Above Median
15	1346363306	$134K	$18.18	3.6× median	Top 10%
16	1982940862	$120K	$7.89	1.6× median	Above Median
17	1508895640	$108K	$19.33	3.8× median	Top 10%
18	1588805451	$98K	$10.07	2.0× median	Above Median
19	1215914288	$90K	$2.32	0.5× median	Below Median
20	Sunrise Treatment Center, Llc Cincinnati, OH · Clinic/Center, Adult Mental Health	$89K	$16.32	3.2× median	Above 75th

Showing top 20 of 239 providers billing this code

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