81161
HCPCS Procedure Code
HCPCS code 81161 is the #1,387 most-billed Medicaid procedure code, with $24.9M in payments across 554K claims from 2018–2024. The national median cost per claim is $104.92.
Total Paid
$24.9M
0.00% of all spending
Total Claims
554K
Providers
40
Avg Cost/Claim
$45
National Cost Distribution
How much do providers bill per claim for 81161? Based on 32 providers billing this code nationally.
Median
$104.92
Average
$112.73
Std Dev
$75.87
Max
$223.20
Percentile Distribution (Cost per Claim)
50% of providers bill between $44.58 and $190.20 per claim for this code.
90% bill between $16.87 and $207.67.
Top 1% bill above $220.31.
About This Procedure
HCPCS code 81161 was billed by 40 providers across 554K claims, totaling $24.9M in Medicaid payments from 2018–2024. This code was used for 482K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$104.92
Providers Billing
32
National Spending
$24.9M
Avg/Median Ratio
1.07×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 81161
| # | Provider | Total Paid |
|---|---|---|
| 1 | Natera Inc. San Carlos, CA · Clinical Medical Laboratory | $19.2M |
| 2 | 1235528225 | $1.5M |
| 3 | Myriad Women's Health, Inc. South San Francisco, CA · Clinical Medical Laboratory | $1.4M |
| 4 | New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine | $426K |
| 5 | 1063892396 | $400K |
| 6 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $360K |
| 7 | New York City Health And Hospitals Corporation Elmhurst, NY · Internal Medicine | $224K |
| 8 | 1609449941 | $215K |
| 9 | New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine | $209K |
| 10 | New York City Health And Hospitals Corporation New York, NY · Internal Medicine | $139K |
| 11 | New York City Health And Hospitals Corporation Brooklyn, NY · Internal Medicine | $128K |
| 12 | 1033124961 | $125K |
| 13 | 1013924372 | $115K |
| 14 | Sherman Abrams Laboratory Inc Brooklyn, NY · Clinical Medical Laboratory | $108K |
| 15 | New York City Health And Hospitals Corporation Jamaica, NY · General Acute Care Hospital | $104K |
| 16 | 1518415991 | $80K |
| 17 | New York City Health And Hospitals Corporation Brooklyn, NY · Internal Medicine | $28K |
| 18 | 1336100858 | $15K |
| 19 | 1447843750 | $15K |
| 20 | 1295331221 | $15K |
Showing top 20 of 40 providers billing this code