81240
HCPCS Procedure Code
HCPCS code 81240 is the #3,575 most-billed Medicaid procedure code, with $1.5M in payments across 94K claims from 2018–2024. The national median cost per claim is $15.20. Costs vary widely — the 90th percentile is $50.60 per claim, 3.3× the median.
Total Paid
$1.5M
0.00% of all spending
Total Claims
94K
Providers
165
Avg Cost/Claim
$16
National Cost Distribution
How much do providers bill per claim for 81240? Based on 135 providers billing this code nationally.
Median
$15.20
Average
$20.46
Std Dev
$19.14
Max
$92.60
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.73 and $27.60 per claim for this code.
90% bill between $1.38 and $50.60.
Top 1% bill above $77.08.
About This Procedure
HCPCS code 81240 was billed by 165 providers across 94K claims, totaling $1.5M in Medicaid payments from 2018–2024. This code was used for 87K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$15.20
Providers Billing
135
National Spending
$1.5M
Avg/Median Ratio
1.35×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 81240
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $155K |
| 2 | 1437585262 | $93K |
| 3 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $90K |
| 4 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $77K |
| 5 | 1215914585 | $67K |
| 6 | 1780620526 | $66K |
| 7 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $53K |
| 8 | Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory | $50K |
| 9 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $46K |
| 10 | 1003221904 | $45K |
| 11 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $39K |
| 12 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $36K |
| 13 | 1376548271 | $32K |
| 14 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $28K |
| 15 | 1215272406 | $24K |
| 16 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $24K |
| 17 | 1447296272 | $23K |
| 18 | 1639541295 | $22K |
| 19 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $21K |
| 20 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $21K |
Showing top 20 of 165 providers billing this code