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#4478 of 11K

88261

HCPCS Procedure Code

HCPCS code 88261 is the #4,478 most-billed Medicaid procedure code, with $561K in payments across 3K claims from 2018–2024. The national median cost per claim is $177.27.

Total Paid

$561K

0.00% of all spending

Total Claims

3K

Providers

10

Avg Cost/Claim

$199

National Cost Distribution

How much do providers bill per claim for 88261? Based on 9 providers billing this code nationally.

Median

$177.27

Average

$170.11

Std Dev

$118.92

Max

$380.07

Percentile Distribution (Cost per Claim)

p10
$43.77
p25
$59.54
Median
$177.27
p75
$263.97
p90
$296.41
p95
$338.24
p99
$371.71

50% of providers bill between $59.54 and $263.97 per claim for this code.

90% bill between $43.77 and $296.41.

Top 1% bill above $371.71.

About This Procedure

HCPCS code 88261 was billed by 10 providers across 3K claims, totaling $561K in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$177.27

Providers Billing

9

National Spending

$561K

Avg/Median Ratio

0.96×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 88261

#ProviderTotal Paid
1City Of Hope National Medical Center

Duarte, CA · General Acute Care Hospital

$286K
21316241102$174K
31669463014$73K
4Laboratory Corporation Of America Holdings

Research Triangle Park, NC · Clinical Medical Laboratory

$18K
51881793750$3K
61649225632$3K
71225226855$1K
8Henry Ford Health System

Detroit, MI · General Acute Care Hospital

$953
91427616002$846
10Medical University Hospital Authority

Charleston, SC · General Acute Care Hospital

$0

Showing top 10 of 10 providers billing this code