88104
HCPCS Procedure Code
HCPCS code 88104 is the #4,100 most-billed Medicaid procedure code, with $849K in payments across 53K claims from 2018–2024. The national median cost per claim is $15.45. Costs vary widely — the 90th percentile is $33.84 per claim, 2.2× the median.
Total Paid
$849K
0.00% of all spending
Total Claims
53K
Providers
93
Avg Cost/Claim
$16
National Cost Distribution
How much do providers bill per claim for 88104? Based on 88 providers billing this code nationally.
Median
$15.45
Average
$20.71
Std Dev
$25.00
Max
$206.82
Percentile Distribution (Cost per Claim)
50% of providers bill between $10.14 and $21.31 per claim for this code.
90% bill between $6.79 and $33.84.
Top 1% bill above $115.65.
About This Procedure
HCPCS code 88104 was billed by 93 providers across 53K claims, totaling $849K in Medicaid payments from 2018–2024. This code was used for 46K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$15.45
Providers Billing
88
National Spending
$849K
Avg/Median Ratio
1.34×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 88104
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1427273598 | $202K |
| 2 | 1225016140 | $124K |
| 3 | Bronxcare Health System Bronx, NY · General Acute Care Hospital | $69K |
| 4 | Sherman Abrams Laboratory Inc Brooklyn, NY · Clinical Medical Laboratory | $56K |
| 5 | 1831256031 | $41K |
| 6 | 1457308637 | $38K |
| 7 | 1669499414 | $30K |
| 8 | 1346230968 | $27K |
| 9 | New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine | $21K |
| 10 | 1568570471 | $18K |
| 11 | Childrens Hospital Of Los Angeles Los Angeles, CA · Case Manager/Care Coordinator | $18K |
| 12 | 1609915784 | $13K |
| 13 | 1992067128 | $12K |
| 14 | 1134102189 | $10K |
| 15 | 1558808204 | $10K |
| 16 | 1093768723 | $9K |
| 17 | 1215921549 | $9K |
| 18 | 1225192610 | $8K |
| 19 | 1558313213 | $8K |
| 20 | 1922116094 | $7K |
Showing top 20 of 93 providers billing this code