87116
HCPCS Procedure Code
HCPCS code 87116 is the #3,975 most-billed Medicaid procedure code, with $966K in payments across 199K claims from 2018–2024. The national median cost per claim is $5.30. Costs vary widely — the 90th percentile is $11.60 per claim, 2.2× the median.
Total Paid
$966K
0.00% of all spending
Total Claims
199K
Providers
319
Avg Cost/Claim
$5
National Cost Distribution
How much do providers bill per claim for 87116? Based on 293 providers billing this code nationally.
Median
$5.30
Average
$6.50
Std Dev
$8.32
Max
$87.26
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.89 and $8.02 per claim for this code.
90% bill between $0.93 and $11.60.
Top 1% bill above $42.84.
About This Procedure
HCPCS code 87116 was billed by 319 providers across 199K claims, totaling $966K in Medicaid payments from 2018–2024. This code was used for 144K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$5.30
Providers Billing
293
National Spending
$966K
Avg/Median Ratio
1.23×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 87116
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1891873303 | $48K |
| 2 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $41K |
| 3 | Permanente Medical Group Inc. Berkeley, CA · Clinical Medical Laboratory | $30K |
| 4 | 1588712285 | $29K |
| 5 | 1053334755 | $25K |
| 6 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $22K |
| 7 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $21K |
| 8 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $21K |
| 9 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $21K |
| 10 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $20K |
| 11 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $20K |
| 12 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $20K |
| 13 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $19K |
| 14 | 1740265347 | $18K |
| 15 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $18K |
| 16 | 1235290651 | $18K |
| 17 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $17K |
| 18 | 1154795581 | $16K |
| 19 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $15K |
| 20 | 1114902814 | $14K |
Showing top 20 of 319 providers billing this code