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#3084 of 11K

88172

HCPCS Procedure Code

HCPCS code 88172 is the #3,084 most-billed Medicaid procedure code, with $2.5M in payments across 67K claims from 2018–2024. The national median cost per claim is $26.08. Costs vary widely — the 90th percentile is $57.25 per claim, 2.2× the median.

Total Paid

$2.5M

0.00% of all spending

Total Claims

67K

Providers

153

Avg Cost/Claim

$38

National Cost Distribution

How much do providers bill per claim for 88172? Based on 148 providers billing this code nationally.

Median

$26.08

Average

$30.64

Std Dev

$23.89

Max

$138.02

Percentile Distribution (Cost per Claim)

p10
$6.14
p25
$12.79
Median
$26.08
p75
$40.07
p90
$57.25
p95
$75.50
p99
$114.96

50% of providers bill between $12.79 and $40.07 per claim for this code.

90% bill between $6.14 and $57.25.

Top 1% bill above $114.96.

About This Procedure

HCPCS code 88172 was billed by 153 providers across 67K claims, totaling $2.5M in Medicaid payments from 2018–2024. This code was used for 59K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$26.08

Providers Billing

148

National Spending

$2.5M

Avg/Median Ratio

1.17×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 88172

#ProviderTotal Paid
11740460583$476K
21841496122$247K
31336461128$149K
41396747861$113K
51740246545$112K
6Englewood Hospital And Medical Center

Englewood, NJ · General Acute Care Hospital

$111K
7University Of Kentucky

Lexington, KY · General Acute Care Hospital

$111K
81053366054$80K
91114160116$74K
10Temple University Hospital Inc

Philadelphia, PA · General Acute Care Hospital

$71K
111275740987$70K
121376544510$60K
131104810308$58K
141306151956$54K
15The Cooper Health System

Camden, NJ · General Acute Care Hospital

$46K
161831132844$41K
17Lsu Health Sciences Center Shreveport Faculty Group Practice

Shreveport, LA · Oral & Maxillofacial Surgery

$36K
18Medical University Hospital Authority

Charleston, SC · General Acute Care Hospital

$36K
191093959355$32K
201144217894$29K

Showing top 20 of 153 providers billing this code