#1918 of 11K

81292

HCPCS Procedure Code

HCPCS code 81292 is the #1,918 most-billed Medicaid procedure code, with $11.5M in payments across 70K claims from 2018–2024. The national median cost per claim is $142.06. Costs vary widely — the 90th percentile is $547.82 per claim, 3.9× the median.

Total Paid

$11.5M

0.00% of all spending

Total Claims

70K

Providers

Avg Cost/Claim

$165

National Cost Distribution

How much do providers bill per claim for 81292? Based on 47 providers billing this code nationally.

Median

$142.06

Average

$225.84

Std Dev

$232.79

Max

$889.85

Percentile Distribution (Cost per Claim)

p10

$21.00

p25

$56.08

Median

$142.06

p75

$285.45

p90

$547.82

p95

$716.01

p99

$877.04

50% of providers bill between $56.08 and $285.45 per claim for this code.

90% bill between $21.00 and $547.82.

Top 1% bill above $877.04.

About This Procedure

HCPCS code 81292 was billed by 62 providers across 70K claims, totaling $11.5M in Medicaid payments from 2018–2024. This code was used for 62K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$142.06

Providers Billing

National Spending

$11.5M

Avg/Median Ratio

1.59×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 81292

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Invitae Corporation San Francisco, CA · Clinical Medical Laboratory	$2.2M	$113.03	0.8× median	Below Median
2	Myriad Genetic Laboratories, Inc. Salt Lake City, UT · Clinical Medical Laboratory	$2.1M	$301.57	2.1× median	Above 75th
3	1013973866	$1.5M	$120.74	0.8× median	Below Median
4	1861568784	$1.4M	$200.39	1.4× median	Above Median
5	1790023547	$640K	$258.95	1.8× median	Above Median
6	1740733708	$624K	$93.94	0.7× median	Below Median
7	Bioconfirm Laboratories Llc Doraville, GA · Clinical Medical Laboratory	$611K	$269.33	1.9× median	Above Median
8	1689971822	$519K	$494.52	3.5× median	Above 75th
9	1003221904	$368K	$613.79	4.3× median	Top 10%
10	1659726487	$230K	$889.85	6.3× median	Top 1%
11	Speciality Screening Llc Wauwatosa, WI · Clinical Medical Laboratory	$222K	$236.77	1.7× median	Above Median
12	1639577091	$196K	$234.79	1.7× median	Above Median
13	Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory	$170K	$117.01	0.8× median	Below Median
14	1649225632	$145K	$559.06	3.9× median	Top 10%
15	Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics	$102K	$142.06	1.0× median	Above Median
16	Crestar Labs Llc Spring Hill, TN · Clinical Medical Laboratory	$85K	$244.88	1.7× median	Above Median
17	1730628439	$78K	$862.01	6.1× median	Top 10%
18	1508215922	$74K	$118.18	0.8× median	Below Median
19	1346641875	$43K	$125.33	0.9× median	Below Median
20	1447843750	$29K	$172.65	1.2× median	Above Median

Showing top 20 of 62 providers billing this code

Related Procedures

81298$9.5M 81295$7.2M 81291$2.7M 81290$2.3M 81301$2.1M

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