81295
HCPCS Procedure Code
HCPCS code 81295 is the #2,278 most-billed Medicaid procedure code, with $7.2M in payments across 74K claims from 2018–2024. The national median cost per claim is $59.11. Costs vary widely — the 90th percentile is $407.18 per claim, 6.9× the median.
Total Paid
$7.2M
0.00% of all spending
Total Claims
74K
Providers
66
Avg Cost/Claim
$97
National Cost Distribution
How much do providers bill per claim for 81295? Based on 52 providers billing this code nationally.
Median
$59.11
Average
$149.55
Std Dev
$205.67
Max
$900.58
Percentile Distribution (Cost per Claim)
50% of providers bill between $16.84 and $198.96 per claim for this code.
90% bill between $2.97 and $407.18.
Top 1% bill above $841.69.
About This Procedure
HCPCS code 81295 was billed by 66 providers across 74K claims, totaling $7.2M in Medicaid payments from 2018–2024. This code was used for 66K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$59.11
Providers Billing
52
National Spending
$7.2M
Avg/Median Ratio
2.53×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 81295
| # | Provider | Total Paid |
|---|---|---|
| 1 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $970K |
| 2 | Myriad Genetic Laboratories, Inc. Salt Lake City, UT · Clinical Medical Laboratory | $921K |
| 3 | 1013973866 | $839K |
| 4 | Speciality Screening Llc Wauwatosa, WI · Clinical Medical Laboratory | $776K |
| 5 | 1861568784 | $658K |
| 6 | 1790023547 | $534K |
| 7 | Bioconfirm Laboratories Llc Doraville, GA · Clinical Medical Laboratory | $525K |
| 8 | 1689971822 | $428K |
| 9 | 1740733708 | $275K |
| 10 | 1003221904 | $238K |
| 11 | 1659726487 | $201K |
| 12 | 1639577091 | $156K |
| 13 | 1457977209 | $96K |
| 14 | 1730628439 | $89K |
| 15 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $72K |
| 16 | Crestar Labs Llc Spring Hill, TN · Clinical Medical Laboratory | $57K |
| 17 | 1902347891 | $50K |
| 18 | 1649225632 | $30K |
| 19 | Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics | $26K |
| 20 | 1346641875 | $24K |
Showing top 20 of 66 providers billing this code