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#2343 of 11K

81200

HCPCS Procedure Code

HCPCS code 81200 is the #2,343 most-billed Medicaid procedure code, with $6.6M in payments across 480K claims from 2018–2024. The national median cost per claim is $17.15. Costs vary widely — the 90th percentile is $46.55 per claim, 2.7× the median.

Total Paid

$6.6M

0.00% of all spending

Total Claims

480K

Providers

62

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for 81200? Based on 53 providers billing this code nationally.

Median

$17.15

Average

$29.50

Std Dev

$35.21

Max

$170.86

Percentile Distribution (Cost per Claim)

p10
$4.37
p25
$8.02
Median
$17.15
p75
$38.36
p90
$46.55
p95
$107.63
p99
$155.56

50% of providers bill between $8.02 and $38.36 per claim for this code.

90% bill between $4.37 and $46.55.

Top 1% bill above $155.56.

About This Procedure

HCPCS code 81200 was billed by 62 providers across 480K claims, totaling $6.6M in Medicaid payments from 2018–2024. This code was used for 418K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$17.15

Providers Billing

53

National Spending

$6.6M

Avg/Median Ratio

1.72×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 81200

#ProviderTotal Paid
1Natera Inc.

San Carlos, CA · Clinical Medical Laboratory

$3.0M
21114222817$910K
31790023547$597K
41689975021$403K
5Myriad Women's Health, Inc.

South San Francisco, CA · Clinical Medical Laboratory

$300K
61235528225$253K
7Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$217K
81326484569$145K
9Laboratory Corporation Of America Holdings

Research Triangle Park, NC · Clinical Medical Laboratory

$103K
101518415991$68K
11Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$65K
12Laboratory Corporation Of America Holdings

Birmingham, AL · Clinical Medical Laboratory

$44K
13New York City Health And Hospitals Corporation

Elmhurst, NY · Internal Medicine

$43K
141063892396$41K
15Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$41K
161104829159$30K
17New York City Health And Hospitals Corporation

Brooklyn, NY · Internal Medicine

$25K
18New York City Health And Hospitals Corporation

New York, NY · Internal Medicine

$22K
191013924372$22K
20Sherman Abrams Laboratory Inc

Brooklyn, NY · Clinical Medical Laboratory

$22K

Showing top 20 of 62 providers billing this code