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#4099 of 11K

84255

HCPCS Procedure Code

HCPCS code 84255 is the #4,099 most-billed Medicaid procedure code, with $851K in payments across 68K claims from 2018–2024. The national median cost per claim is $13.10.

Total Paid

$851K

0.00% of all spending

Total Claims

68K

Providers

98

Avg Cost/Claim

$12

National Cost Distribution

How much do providers bill per claim for 84255? Based on 95 providers billing this code nationally.

Median

$13.10

Average

$14.31

Std Dev

$10.83

Max

$73.39

Percentile Distribution (Cost per Claim)

p10
$3.68
p25
$7.04
Median
$13.10
p75
$19.06
p90
$22.98
p95
$27.86
p99
$62.18

50% of providers bill between $7.04 and $19.06 per claim for this code.

90% bill between $3.68 and $22.98.

Top 1% bill above $62.18.

About This Procedure

HCPCS code 84255 was billed by 98 providers across 68K claims, totaling $851K in Medicaid payments from 2018–2024. This code was used for 66K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.10

Providers Billing

95

National Spending

$851K

Avg/Median Ratio

1.09×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 84255

#ProviderTotal Paid
1Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$175K
2Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$147K
3Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$78K
4Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$33K
5Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$33K
6Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$29K
7Childrens Hospital Of Los Angeles

Los Angeles, CA · Case Manager/Care Coordinator

$26K
8Rochester General Hospital-lab

Rochester, NY · Clinical Medical Laboratory

$25K
91447296272$19K
101811997711$19K
11Accu Reference Medical Lab, Llc

Linden, NJ · Clinical Medical Laboratory

$17K
12Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$17K
131033124961$16K
14Empire City Laboratories, Inc

Brooklyn, NY · Clinical Medical Laboratory

$15K
151770529513$15K
161942226006$14K
17Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$14K
181043271539$13K
19Saint Francis Hospital And Medical Center

Hartford, CT · General Acute Care Hospital

$11K
20Mayo Collaborative Services, Inc

Rochester, MN · Clinical Medical Laboratory

$10K

Showing top 20 of 98 providers billing this code

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