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#2208 of 11K

87561

HCPCS Procedure Code

HCPCS code 87561 is the #2,208 most-billed Medicaid procedure code, with $7.9M in payments across 364K claims from 2018–2024. The national median cost per claim is $9.23. Costs vary widely — the 90th percentile is $32.54 per claim, 3.5× the median.

Total Paid

$7.9M

0.00% of all spending

Total Claims

364K

Providers

76

Avg Cost/Claim

$22

National Cost Distribution

How much do providers bill per claim for 87561? Based on 70 providers billing this code nationally.

Median

$9.23

Average

$14.19

Std Dev

$13.15

Max

$46.56

Percentile Distribution (Cost per Claim)

p10
$0.84
p25
$2.60
Median
$9.23
p75
$24.98
p90
$32.54
p95
$37.05
p99
$45.62

50% of providers bill between $2.60 and $24.98 per claim for this code.

90% bill between $0.84 and $32.54.

Top 1% bill above $45.62.

About This Procedure

HCPCS code 87561 was billed by 76 providers across 364K claims, totaling $7.9M in Medicaid payments from 2018–2024. This code was used for 307K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.23

Providers Billing

70

National Spending

$7.9M

Avg/Median Ratio

1.54×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 87561

#ProviderTotal Paid
1Physicians Group Laboratories, Llc

Houma, LA · Clinical Medical Laboratory

$6.6M
21164775862$297K
31467066860$206K
41407313760$135K
51174009245$120K
61457977209$116K
71659382067$71K
81346514619$56K
91346314564$49K
101508326851$33K
111841799764$18K
121043229735$10K
131174137368$9K
141104517424$9K
151326002171$8K
161649687724$8K
171750944526$7K
181679816201$7K
191558808204$7K
201710347703$6K

Showing top 20 of 76 providers billing this code