81290
HCPCS Procedure Code
HCPCS code 81290 is the #3,186 most-billed Medicaid procedure code, with $2.3M in payments across 152K claims from 2018–2024. The national median cost per claim is $9.82. Costs vary widely — the 90th percentile is $34.24 per claim, 3.5× the median.
Total Paid
$2.3M
0.00% of all spending
Total Claims
152K
Providers
41
Avg Cost/Claim
$15
National Cost Distribution
How much do providers bill per claim for 81290? Based on 37 providers billing this code nationally.
Median
$9.82
Average
$16.80
Std Dev
$24.08
Max
$136.52
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.24 and $17.53 per claim for this code.
90% bill between $3.33 and $34.24.
Top 1% bill above $110.31.
About This Procedure
HCPCS code 81290 was billed by 41 providers across 152K claims, totaling $2.3M in Medicaid payments from 2018–2024. This code was used for 134K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$9.82
Providers Billing
37
National Spending
$2.3M
Avg/Median Ratio
1.71×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 81290
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1790023547 | $584K |
| 2 | 1114222817 | $561K |
| 3 | 1689975021 | $231K |
| 4 | Myriad Women's Health, Inc. South San Francisco, CA · Clinical Medical Laboratory | $217K |
| 5 | 1326484569 | $119K |
| 6 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $105K |
| 7 | Natera Inc. San Carlos, CA · Clinical Medical Laboratory | $104K |
| 8 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $55K |
| 9 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $54K |
| 10 | 1518415991 | $47K |
| 11 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $38K |
| 12 | 1063892396 | $35K |
| 13 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $25K |
| 14 | Sherman Abrams Laboratory Inc Brooklyn, NY · Clinical Medical Laboratory | $17K |
| 15 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $13K |
| 16 | 1265418669 | $12K |
| 17 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $7K |
| 18 | 1568446755 | $7K |
| 19 | 1730481078 | $7K |
| 20 | Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory | $6K |
Showing top 20 of 41 providers billing this code