87536
HIV-1 detection by nucleic acid, quantitative
HIV-1 detection by nucleic acid, quantitative is the #592 most-billed Medicaid procedure code, with $136.5M in payments across 2.9M claims from 2018–2024. The national median cost per claim is $51.73.
Total Paid
$136.5M
0.01% of all spending
Total Claims
2.9M
Providers
751
Avg Cost/Claim
$47
National Cost Distribution
How much do providers bill per claim for 87536? Based on 693 providers billing this code nationally.
Median
$51.73
Average
$56.51
Std Dev
$44.47
Max
$705.53
Percentile Distribution (Cost per Claim)
50% of providers bill between $32.34 and $74.25 per claim for this code.
90% bill between $12.28 and $93.13.
Top 1% bill above $216.23.
About This Procedure
HCPCS code 87536 (HIV-1 detection by nucleic acid, quantitative) was billed by 751 providers across 2.9M claims, totaling $136.5M in Medicaid payments from 2018–2024. This code was used for 2.7M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$51.73
Providers Billing
693
National Spending
$136.5M
Avg/Median Ratio
1.09×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 87536
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $13.7M |
| 2 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $8.3M |
| 3 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $6.6M |
| 4 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $4.1M |
| 5 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $4.0M |
| 6 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $3.0M |
| 7 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $2.7M |
| 8 | Laboratory Corporation Of America San Diego, CA · Clinical Medical Laboratory | $2.4M |
| 9 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $2.2M |
| 10 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $2.1M |
| 11 | Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory | $1.9M |
| 12 | 1447477252 | $1.8M |
| 13 | 1578597993 | $1.8M |
| 14 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $1.5M |
| 15 | Mount Sinai Hospital New York, NY · Ambulance | $1.5M |
| 16 | 1447233861 | $1.4M |
| 17 | University Hospital Newark, NJ · General Acute Care Hospital | $1.4M |
| 18 | Quest Diagnostics Massachusetts Llc Marlborough, MA · Clinical Medical Laboratory | $1.3M |
| 19 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $1.2M |
| 20 | St Lukes Roosevelt Hospital Center New York, NY · Case Management | $1.2M |
Showing top 20 of 751 providers billing this code