#4252 of 11K

87071

HCPCS Procedure Code

HCPCS code 87071 is the #4,252 most-billed Medicaid procedure code, with $713K in payments across 121K claims from 2018–2024. The national median cost per claim is $3.64. Costs vary widely — the 90th percentile is $10.93 per claim, 3.0× the median.

Total Paid

$713K

0.00% of all spending

Total Claims

121K

Providers

161

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 87071? Based on 145 providers billing this code nationally.

Median

$3.64

Average

$6.36

Std Dev

$11.45

Max

$108.73

Percentile Distribution (Cost per Claim)

p10

$0.29

p25

$0.96

Median

$3.64

p75

$7.67

p90

$10.93

p95

$20.58

p99

$48.16

50% of providers bill between $0.96 and $7.67 per claim for this code.

90% bill between $0.29 and $10.93.

Top 1% bill above $48.16.

About This Procedure

HCPCS code 87071 was billed by 161 providers across 121K claims, totaling $713K in Medicaid payments from 2018–2024. This code was used for 110K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3.64

Providers Billing

145

National Spending

$713K

Avg/Median Ratio

1.75×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 87071

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1356375307	$88K	$26.45	7.3× median	Top 10%
2	1790780047	$85K	$7.57	2.1× median	Above Median
3	1104821305	$73K	$54.53	15.0× median	Top 1%
4	Holyoke Medical Center, Inc. Holyoke, MA · Clinic/Center, Adult Mental Health	$70K	$8.53	2.3× median	Above 75th
5	1619931466	$55K	$8.76	2.4× median	Above 75th
6	1073517058	$30K	$18.45	5.1× median	Top 10%
7	1730287574	$22K	$8.27	2.3× median	Above 75th
8	Centers Lab Nj Llc Cedar Knolls, NJ · Clinical Medical Laboratory	$17K	$2.16	0.6× median	Below Median
9	1841241833	$16K	$4.84	1.3× median	Above Median
10	Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care	$13K	$7.77	2.1× median	Above 75th
11	Southern Ohio Medical Center Portsmouth, OH · Clinical Medical Laboratory	$12K	$6.36	1.7× median	Above Median
12	1710065933	$11K	$4.14	1.1× median	Above Median
13	1013981554	$10K	$5.59	1.5× median	Above Median
14	1598736159	$10K	$108.73	29.9× median	Top 1%
15	1164495255	$10K	$12.37	3.4× median	Top 10%
16	1295702728	$10K	$8.21	2.3× median	Above 75th
17	1659322360	$10K	$2.87	0.8× median	Below Median
18	1144209271	$9K	$3.41	0.9× median	Below Median
19	1245846682	$8K	$7.76	2.1× median	Above 75th
20	1104859131	$8K	$2.58	0.7× median	Below Median

Showing top 20 of 161 providers billing this code

Related Procedures

87070Bacterial culture, any source except blood or urine$134.4M 87081Culture screening for pathogenic organisms$103.9M 87077Bacterial culture, aerobic, additional methods required$75.2M 87075$8.4M 87076$1.2M

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