81260
HCPCS Procedure Code
HCPCS code 81260 is the #2,579 most-billed Medicaid procedure code, with $4.9M in payments across 496K claims from 2018–2024. The national median cost per claim is $10.67. Costs vary widely — the 90th percentile is $33.98 per claim, 3.2× the median.
Total Paid
$4.9M
0.00% of all spending
Total Claims
496K
Providers
68
Avg Cost/Claim
$10
National Cost Distribution
How much do providers bill per claim for 81260? Based on 55 providers billing this code nationally.
Median
$10.67
Average
$18.17
Std Dev
$24.50
Max
$143.70
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.63 and $26.85 per claim for this code.
90% bill between $1.08 and $33.98.
Top 1% bill above $119.62.
About This Procedure
HCPCS code 81260 was billed by 68 providers across 496K claims, totaling $4.9M in Medicaid payments from 2018–2024. This code was used for 434K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$10.67
Providers Billing
55
National Spending
$4.9M
Avg/Median Ratio
1.70×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 81260
| # | Provider | Total Paid |
|---|---|---|
| 1 | Natera Inc. San Carlos, CA · Clinical Medical Laboratory | $2.3M |
| 2 | 1114222817 | $616K |
| 3 | 1790023547 | $583K |
| 4 | 1689975021 | $240K |
| 5 | Myriad Women's Health, Inc. South San Francisco, CA · Clinical Medical Laboratory | $239K |
| 6 | 1235528225 | $180K |
| 7 | 1326484569 | $120K |
| 8 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $105K |
| 9 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $58K |
| 10 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $54K |
| 11 | 1518415991 | $47K |
| 12 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $40K |
| 13 | 1063892396 | $38K |
| 14 | New York City Health And Hospitals Corporation Elmhurst, NY · Internal Medicine | $36K |
| 15 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $26K |
| 16 | New York City Health And Hospitals Corporation Brooklyn, NY · Internal Medicine | $21K |
| 17 | New York City Health And Hospitals Corporation New York, NY · Internal Medicine | $18K |
| 18 | 1013924372 | $18K |
| 19 | 1033124961 | $17K |
| 20 | Sherman Abrams Laboratory Inc Brooklyn, NY · Clinical Medical Laboratory | $16K |
Showing top 20 of 68 providers billing this code