#2590 of 11K

88381

HCPCS Procedure Code

HCPCS code 88381 is the #2,590 most-billed Medicaid procedure code, with $4.7M in payments across 79K claims from 2018–2024. The national median cost per claim is $33.49. Costs vary widely — the 90th percentile is $80.71 per claim, 2.4× the median.

Total Paid

$4.7M

0.00% of all spending

Total Claims

79K

Providers

Avg Cost/Claim

$60

National Cost Distribution

How much do providers bill per claim for 88381? Based on 40 providers billing this code nationally.

Median

$33.49

Average

$41.47

Std Dev

$36.66

Max

$180.95

Percentile Distribution (Cost per Claim)

p10

$10.58

p25

$19.42

Median

$33.49

p75

$48.80

p90

$80.71

p95

$104.69

p99

$166.40

50% of providers bill between $19.42 and $48.80 per claim for this code.

90% bill between $10.58 and $80.71.

Top 1% bill above $166.40.

About This Procedure

HCPCS code 88381 was billed by 43 providers across 79K claims, totaling $4.7M in Medicaid payments from 2018–2024. This code was used for 63K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$33.49

Providers Billing

National Spending

$4.7M

Avg/Median Ratio

1.24×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 88381

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1013013002	$2.5M	$89.90	2.7× median	Top 10%
2	1013973866	$1.3M	$42.38	1.3× median	Above Median
3	1740733708	$218K	$50.74	1.5× median	Above 75th
4	1770833121	$135K	$41.40	1.2× median	Above Median
5	Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory	$81K	$33.85	1.0× median	Above Median
6	Invitae Corporation San Francisco, CA · Clinical Medical Laboratory	$77K	$48.52	1.4× median	Above Median
7	City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital	$73K	$180.95	5.4× median	Top 1%
8	Myriad Genetic Laboratories, Inc. Salt Lake City, UT · Clinical Medical Laboratory	$67K	$43.70	1.3× median	Above Median
9	1639200215	$66K	$79.68	2.4× median	Above 75th
10	1821253584	$52K	$49.66	1.5× median	Above 75th
11	1720688054	$37K	$60.95	1.8× median	Above 75th
12	1871886366	$28K	$48.11	1.4× median	Above Median
13	1740391499	$25K	$41.66	1.2× median	Above Median
14	1043344435	$11K	$102.64	3.1× median	Top 10%
15	1679580286	$10K	$24.01	0.7× median	Below Median
16	Mayo Collaborative Services, Inc Rochester, MN · Clinical Medical Laboratory	$9K	$70.51	2.1× median	Above 75th
17	1376709535	$8K	$18.03	0.5× median	Below Median
18	1649471467	$7K	$21.71	0.6× median	Below Median
19	1609826304	$7K	$16.98	0.5× median	Below Median
20	1316984388	$5K	$20.23	0.6× median	Below Median

Showing top 20 of 43 providers billing this code

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