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#4331 of 11K

87538

HCPCS Procedure Code

HCPCS code 87538 is the #4,331 most-billed Medicaid procedure code, with $656K in payments across 48K claims from 2018–2024. The national median cost per claim is $20.47.

Total Paid

$656K

0.00% of all spending

Total Claims

48K

Providers

41

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for 87538? Based on 37 providers billing this code nationally.

Median

$20.47

Average

$25.17

Std Dev

$33.30

Max

$213.78

Percentile Distribution (Cost per Claim)

p10
$5.23
p25
$14.32
Median
$20.47
p75
$27.38
p90
$33.50
p95
$36.16
p99
$150.14

50% of providers bill between $14.32 and $27.38 per claim for this code.

90% bill between $5.23 and $33.50.

Top 1% bill above $150.14.

About This Procedure

HCPCS code 87538 was billed by 41 providers across 48K claims, totaling $656K in Medicaid payments from 2018–2024. This code was used for 46K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$20.47

Providers Billing

37

National Spending

$656K

Avg/Median Ratio

1.23×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87538

#ProviderTotal Paid
1Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$143K
2Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$86K
3Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$66K
4State Of New Mexico

Santa Fe, NM · Public Health or Welfare

$61K
5Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$54K
6Laboratory Corporation Of America

San Diego, CA · Clinical Medical Laboratory

$36K
7Laboratory Corporation Of America

Tampa, FL · Clinical Medical Laboratory

$23K
8Laboratory Corporation Of America Holdings

Birmingham, AL · Clinical Medical Laboratory

$19K
9Permanente Medical Group Inc.

Berkeley, CA · Clinical Medical Laboratory

$19K
101699538983$18K
11Laboratory Corporation Of America

Seattle, WA · Clinical Medical Laboratory

$16K
12University Of Rochester

Rochester, NY · General Acute Care Hospital

$15K
13Carolinas Medical Center

Charlotte, NC · General Acute Care Hospital

$13K
141134235039$11K
151104829159$10K
16Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$10K
17Laboratory Corporation Of America

Phoenix, AZ · Clinical Medical Laboratory

$9K
18New York City Health And Hospitals Corporation

Brooklyn, NY · Internal Medicine

$8K
191255071387$8K
201225033814$5K

Showing top 20 of 41 providers billing this code