87497
HCPCS Procedure Code
HCPCS code 87497 is the #1,589 most-billed Medicaid procedure code, with $18.4M in payments across 717K claims from 2018–2024. The national median cost per claim is $19.10. Costs vary widely — the 90th percentile is $55.42 per claim, 2.9× the median.
Total Paid
$18.4M
0.00% of all spending
Total Claims
717K
Providers
308
Avg Cost/Claim
$26
National Cost Distribution
How much do providers bill per claim for 87497? Based on 299 providers billing this code nationally.
Median
$19.10
Average
$29.53
Std Dev
$53.81
Max
$822.11
Percentile Distribution (Cost per Claim)
50% of providers bill between $9.24 and $37.47 per claim for this code.
90% bill between $5.05 and $55.42.
Top 1% bill above $154.78.
About This Procedure
HCPCS code 87497 was billed by 308 providers across 717K claims, totaling $18.4M in Medicaid payments from 2018–2024. This code was used for 456K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$19.10
Providers Billing
299
National Spending
$18.4M
Avg/Median Ratio
1.55×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 87497
| # | Provider | Total Paid |
|---|---|---|
| 1 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $982K |
| 2 | Childrens Hospital Of Los Angeles Los Angeles, CA · Case Manager/Care Coordinator | $718K |
| 3 | 1891940326 | $681K |
| 4 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $491K |
| 5 | Nyu Langone Hospitals New York, NY · Clinic/Center, Oncology | $487K |
| 6 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $422K |
| 7 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $422K |
| 8 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $420K |
| 9 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $403K |
| 10 | 1902803315 | $402K |
| 11 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $388K |
| 12 | 1639172372 | $386K |
| 13 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $386K |
| 14 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $345K |
| 15 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $322K |
| 16 | University Of California Irvine Orange, CA · General Acute Care Hospital | $317K |
| 17 | Seattle Children's Hospital Seattle, WA · Prosthetic/Orthotic Supplier | $297K |
| 18 | 1154392231 | $289K |
| 19 | 1164493847 | $282K |
| 20 | Children's Health System Of Texas Dallas, TX · General Acute Care Hospital Children | $267K |
Showing top 20 of 308 providers billing this code