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#3022 of 11K

81291

HCPCS Procedure Code

HCPCS code 81291 is the #3,022 most-billed Medicaid procedure code, with $2.7M in payments across 455K claims from 2018–2024. The national median cost per claim is $6.85. Costs vary widely — the 90th percentile is $29.08 per claim, 4.2× the median.

Total Paid

$2.7M

0.00% of all spending

Total Claims

455K

Providers

165

Avg Cost/Claim

$6

National Cost Distribution

How much do providers bill per claim for 81291? Based on 121 providers billing this code nationally.

Median

$6.85

Average

$12.46

Std Dev

$16.13

Max

$96.00

Percentile Distribution (Cost per Claim)

p10
$1.23
p25
$2.59
Median
$6.85
p75
$13.85
p90
$29.08
p95
$49.72
p99
$69.41

50% of providers bill between $2.59 and $13.85 per claim for this code.

90% bill between $1.23 and $29.08.

Top 1% bill above $69.41.

About This Procedure

HCPCS code 81291 was billed by 165 providers across 455K claims, totaling $2.7M in Medicaid payments from 2018–2024. This code was used for 409K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.85

Providers Billing

121

National Spending

$2.7M

Avg/Median Ratio

1.82×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 81291

#ProviderTotal Paid
11235363052$1.7M
21467850859$186K
3Millennium Health Llc

San Diego, CA · Clinical Medical Laboratory

$164K
4Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$74K
5Laboratory Corporation Of America Holdings

Research Triangle Park, NC · Clinical Medical Laboratory

$68K
61437585262$37K
7Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$27K
8Quest Diagnostics Clinical Laboratories Inc

Tucker, GA · Clinical Medical Laboratory

$26K
9Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$26K
10Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$23K
11Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$21K
12Gravity Diagnostics, Llc

Covington, KY · Clinical Medical Laboratory

$20K
131821360017$20K
141518415991$19K
15Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$18K
161639541295$17K
17Quest Diagnostics Clinical Laboratories Inc

Irving, TX · Clinical Medical Laboratory

$17K
181750373908$17K
191275971707$17K
20Natera Inc.

San Carlos, CA · Clinical Medical Laboratory

$15K

Showing top 20 of 165 providers billing this code