81185
HCPCS Procedure Code
HCPCS code 81185 is the #3,631 most-billed Medicaid procedure code, with $1.4M in payments across 9K claims from 2018–2024. The national median cost per claim is $55.85. Costs vary widely — the 90th percentile is $358.27 per claim, 6.4× the median.
Total Paid
$1.4M
0.00% of all spending
Total Claims
9K
Providers
18
Avg Cost/Claim
$160
National Cost Distribution
How much do providers bill per claim for 81185? Based on 15 providers billing this code nationally.
Median
$55.85
Average
$145.08
Std Dev
$155.94
Max
$489.64
Percentile Distribution (Cost per Claim)
50% of providers bill between $27.96 and $249.34 per claim for this code.
90% bill between $13.03 and $358.27.
Top 1% bill above $479.11.
About This Procedure
HCPCS code 81185 was billed by 18 providers across 9K claims, totaling $1.4M in Medicaid payments from 2018–2024. This code was used for 8K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$55.85
Providers Billing
15
National Spending
$1.4M
Avg/Median Ratio
2.60×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 81185
| # | Provider | Total Paid |
|---|---|---|
| 1 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $663K |
| 2 | 1457977209 | $271K |
| 3 | Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics | $235K |
| 4 | 1609388842 | $182K |
| 5 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $29K |
| 6 | 1447843750 | $10K |
| 7 | 1629109137 | $5K |
| 8 | 1528653334 | $3K |
| 9 | 1275292294 | $3K |
| 10 | 1013525286 | $2K |
| 11 | 1518713072 | $1K |
| 12 | 1760189898 | $829 |
| 13 | 1770207607 | $677 |
| 14 | 1871169706 | $670 |
| 15 | 1932843836 | $34 |
| 16 | 1881334290 | $0 |
| 17 | 1851059588 | $0 |
| 18 | 1518366426 | $0 |
Showing top 18 of 18 providers billing this code