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#419 of 11K

81025

Urine pregnancy test

Urine pregnancy test is the #419 most-billed Medicaid procedure code, with $246.9M in payments across 42.2M claims from 2018–2024. The national median cost per claim is $4.81.

Total Paid

$246.9M

0.02% of all spending

Total Claims

42.2M

Providers

17K

Avg Cost/Claim

$6

National Cost Distribution

How much do providers bill per claim for 81025? Based on 16K providers billing this code nationally.

Median

$4.81

Average

$6.11

Std Dev

$15.60

Max

$721.71

Percentile Distribution (Cost per Claim)

p10
$0.61
p25
$2.50
Median
$4.81
p75
$6.54
p90
$8.03
p95
$11.24
p99
$43.85

50% of providers bill between $2.50 and $6.54 per claim for this code.

90% bill between $0.61 and $8.03.

Top 1% bill above $43.85.

About This Procedure

HCPCS code 81025 (Urine pregnancy test) was billed by 17K providers across 42.2M claims, totaling $246.9M in Medicaid payments from 2018–2024. This code was used for 37.5M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$4.81

Providers Billing

16K

National Spending

$246.9M

Avg/Median Ratio

1.27×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81025

#ProviderTotal Paid
1Spartanburg Medical Center

Spartanburg, SC · Ambulance

$4.4M
21154373843$3.9M
31134187842$2.8M
4Truman Medical Center, Incorporated

Kansas City, MO · General Acute Care Hospital

$2.7M
51407301211$2.6M
6Planned Parenthood/orange And San Bernardino Counties, Inc.

Orange, CA · Clinic/Center, Ambulatory Family Planning Facility

$1.9M
71174500458$1.9M
81376686600$1.7M
91487868097$1.5M
101942247044$1.5M
11Antelope Valley Health Care District

Lancaster, CA · General Acute Care Hospital

$1.4M
121205889458$1.4M
131649726738$1.4M
14Yukon-kuskokwim Health Corporation

Bethel, AK · General Acute Care Hospital Rural

$1.3M
151639186760$1.2M
16Alaska Native Tribal Health Consortium

Anchorage, AK · General Acute Care Hospital

$1.1M
171508856535$1.1M
181871678458$1.1M
19Mary Imogene Bassett Hospital

Cooperstown, NY · General Acute Care Hospital, Rural

$1.1M
20Charleston Area Medical Center Inc

Charleston, WV · General Acute Care Hospital

$1.1M

Showing top 20 of 17K providers billing this code

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