81213
HCPCS Procedure Code
HCPCS code 81213 is the #3,035 most-billed Medicaid procedure code, with $2.7M in payments across 13K claims from 2018–2024. The national median cost per claim is $133.18. Costs vary widely — the 90th percentile is $462.21 per claim, 3.5× the median.
Total Paid
$2.7M
0.00% of all spending
Total Claims
13K
Providers
8
Avg Cost/Claim
$216
National Cost Distribution
How much do providers bill per claim for 81213? Based on 7 providers billing this code nationally.
Median
$133.18
Average
$210.75
Std Dev
$181.64
Max
$463.39
Percentile Distribution (Cost per Claim)
50% of providers bill between $80.79 and $340.72 per claim for this code.
90% bill between $51.13 and $462.21.
Top 1% bill above $463.28.
About This Procedure
HCPCS code 81213 was billed by 8 providers across 13K claims, totaling $2.7M in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$133.18
Providers Billing
7
National Spending
$2.7M
Avg/Median Ratio
1.58×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 81213
| # | Provider | Total Paid |
|---|---|---|
| 1 | Myriad Genetic Laboratories, Inc. Salt Lake City, UT · Clinical Medical Laboratory | $2.2M |
| 2 | 1790023547 | $280K |
| 3 | 1861568784 | $238K |
| 4 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $18K |
| 5 | 1811932940 | $6K |
| 6 | 1629109137 | $5K |
| 7 | 1750373908 | $606 |
| 8 | 1376645135 | $0 |
Showing top 8 of 8 providers billing this code