Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#2167 of 11K

87420

HCPCS Procedure Code

HCPCS code 87420 is the #2,167 most-billed Medicaid procedure code, with $8.3M in payments across 770K claims from 2018–2024. The national median cost per claim is $9.78. Costs vary widely — the 90th percentile is $22.03 per claim, 2.3× the median.

Total Paid

$8.3M

0.00% of all spending

Total Claims

770K

Providers

2K

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for 87420? Based on 1K providers billing this code nationally.

Median

$9.78

Average

$13.39

Std Dev

$24.52

Max

$420.81

Percentile Distribution (Cost per Claim)

p10
$0.77
p25
$3.55
Median
$9.78
p75
$13.60
p90
$22.03
p95
$40.36
p99
$103.25

50% of providers bill between $3.55 and $13.60 per claim for this code.

90% bill between $0.77 and $22.03.

Top 1% bill above $103.25.

About This Procedure

HCPCS code 87420 was billed by 2K providers across 770K claims, totaling $8.3M in Medicaid payments from 2018–2024. This code was used for 717K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.78

Providers Billing

1K

National Spending

$8.3M

Avg/Median Ratio

1.37×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87420

#ProviderTotal Paid
11396731105$416K
21063426823$200K
31144228446$134K
41649367269$123K
51366496937$117K
6Mcallen Hospitals L P

Edinburg, TX · General Acute Care Hospital

$103K
7Alaska Native Tribal Health Consortium

Anchorage, AK · General Acute Care Hospital

$98K
81609066257$96K
91598713075$89K
101457382483$85K
11Christus Santa Rosa Health Care Corporation

San Antonio, TX · General Acute Care Hospital

$84K
121508935891$84K
13Antelope Valley Health Care District

Lancaster, CA · General Acute Care Hospital

$81K
141851940035$80K
151134394539$80K
16Chca Bayshore Lp

Pasadena, TX · Clinic/Center, Ambulatory Surgical

$79K
17Port City Operating Company Llc

Stockton, CA · General Acute Care Hospital

$73K
181093760944$73K
191114081056$73K
201467448498$70K

Showing top 20 of 2K providers billing this code