81203
HCPCS Procedure Code
HCPCS code 81203 is the #4,287 most-billed Medicaid procedure code, with $692K in payments across 6K claims from 2018–2024. The national median cost per claim is $18.36. Costs vary widely — the 90th percentile is $125.27 per claim, 6.8× the median.
Total Paid
$692K
0.00% of all spending
Total Claims
6K
Providers
14
Avg Cost/Claim
$113
National Cost Distribution
How much do providers bill per claim for 81203? Based on 11 providers billing this code nationally.
Median
$18.36
Average
$56.52
Std Dev
$72.41
Max
$231.44
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.59 and $82.86 per claim for this code.
90% bill between $2.43 and $125.27.
Top 1% bill above $220.82.
About This Procedure
HCPCS code 81203 was billed by 14 providers across 6K claims, totaling $692K in Medicaid payments from 2018–2024. This code was used for 6K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$18.36
Providers Billing
11
National Spending
$692K
Avg/Median Ratio
3.08×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 81203
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1316311863 | $598K |
| 2 | 1639577091 | $51K |
| 3 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $17K |
| 4 | 1790023547 | $9K |
| 5 | 1609388842 | $6K |
| 6 | Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics | $4K |
| 7 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $3K |
| 8 | 1861568784 | $1K |
| 9 | 1417407727 | $1K |
| 10 | 1518713072 | $252 |
| 11 | 1336598325 | $200 |
| 12 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $0 |
| 13 | 1699172866 | $0 |
| 14 | 1174009245 | $0 |
Showing top 14 of 14 providers billing this code