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#3839 of 11K

81175

HCPCS Procedure Code

HCPCS code 81175 is the #3,839 most-billed Medicaid procedure code, with $1.1M in payments across 11K claims from 2018–2024. The national median cost per claim is $73.10. Costs vary widely — the 90th percentile is $150.51 per claim, 2.1× the median.

Total Paid

$1.1M

0.00% of all spending

Total Claims

11K

Providers

13

Avg Cost/Claim

$99

National Cost Distribution

How much do providers bill per claim for 81175? Based on 10 providers billing this code nationally.

Median

$73.10

Average

$102.58

Std Dev

$126.53

Max

$445.69

Percentile Distribution (Cost per Claim)

p10
$21.30
p25
$38.52
Median
$73.10
p75
$104.78
p90
$150.51
p95
$298.10
p99
$416.18

50% of providers bill between $38.52 and $104.78 per claim for this code.

90% bill between $21.30 and $150.51.

Top 1% bill above $416.18.

About This Procedure

HCPCS code 81175 was billed by 13 providers across 11K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$73.10

Providers Billing

10

National Spending

$1.1M

Avg/Median Ratio

1.40×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81175

#ProviderTotal Paid
11013973866$501K
2Invitae Corporation

San Francisco, CA · Clinical Medical Laboratory

$478K
3Genedx Llc

Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics

$72K
41457977209$23K
51447843750$18K
6Laboratory Corporation Of America Holdings

Research Triangle Park, NC · Clinical Medical Laboratory

$5K
71528653334$3K
81275292294$3K
91518713072$1K
101932843836$28
111013525286$0
121760189898$0
131881334290$0

Showing top 13 of 13 providers billing this code