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#6474 of 11K

87154

HCPCS Procedure Code

HCPCS code 87154 is the #6,474 most-billed Medicaid procedure code, with $62K in payments across 2K claims from 2018–2024. The national median cost per claim is $25.22. Costs vary widely — the 90th percentile is $139.31 per claim, 5.5× the median.

Total Paid

$62K

0.00% of all spending

Total Claims

2K

Providers

31

Avg Cost/Claim

$25

National Cost Distribution

How much do providers bill per claim for 87154? Based on 18 providers billing this code nationally.

Median

$25.22

Average

$51.14

Std Dev

$55.51

Max

$175.36

Percentile Distribution (Cost per Claim)

p10
$6.04
p25
$10.42
Median
$25.22
p75
$81.02
p90
$139.31
p95
$155.13
p99
$171.31

50% of providers bill between $10.42 and $81.02 per claim for this code.

90% bill between $6.04 and $139.31.

Top 1% bill above $171.31.

About This Procedure

HCPCS code 87154 was billed by 31 providers across 2K claims, totaling $62K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$25.22

Providers Billing

18

National Spending

$62K

Avg/Median Ratio

2.03×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 87154

#ProviderTotal Paid
1County Of Ventura

Ventura, CA · Clinic/Center, Emergency Care

$10K
2Ohiohealth Corporation

Columbus, OH · General Acute Care Hospital

$9K
3Ohio State University Hospitals

Columbus, OH · General Acute Care Hospital

$9K
41942257191$7K
51710913462$6K
6Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$6K
7Florida Clinical Practice Association Inc

Gainesville, FL · Surgery

$6K
8Dayton Osteopathic Hospital

Dayton, OH · General Acute Care Hospital

$3K
91255313664$2K
101699720086$921
111649220872$779
12Aurora Health Care Metro, Inc.

Milwaukee, WI · Internal Medicine, Hematology & Oncology

$731
131144277633$478
141104870187$369
15The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$356
16Hmh Hospitals Corporation

Hackensack, NJ · Ambulance

$313
171831188275$230
181285739938$5
19Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$0
201144228446$0

Showing top 20 of 31 providers billing this code