81311
HCPCS Procedure Code
HCPCS code 81311 is the #3,273 most-billed Medicaid procedure code, with $2.1M in payments across 36K claims from 2018–2024. The national median cost per claim is $57.29. Costs vary widely — the 90th percentile is $155.25 per claim, 2.7× the median.
Total Paid
$2.1M
0.00% of all spending
Total Claims
36K
Providers
24
Avg Cost/Claim
$57
National Cost Distribution
How much do providers bill per claim for 81311? Based on 16 providers billing this code nationally.
Median
$57.29
Average
$69.84
Std Dev
$70.09
Max
$256.35
Percentile Distribution (Cost per Claim)
50% of providers bill between $32.29 and $71.78 per claim for this code.
90% bill between $9.27 and $155.25.
Top 1% bill above $249.93.
About This Procedure
HCPCS code 81311 was billed by 24 providers across 36K claims, totaling $2.1M in Medicaid payments from 2018–2024. This code was used for 32K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$57.29
Providers Billing
16
National Spending
$2.1M
Avg/Median Ratio
1.22×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 81311
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1013973866 | $1.0M |
| 2 | 1184045619 | $287K |
| 3 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $262K |
| 4 | 1740733708 | $237K |
| 5 | 1457977209 | $59K |
| 6 | 1447843750 | $42K |
| 7 | 1447437355 | $36K |
| 8 | 1205834769 | $30K |
| 9 | 1518415991 | $27K |
| 10 | 1134438427 | $20K |
| 11 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $9K |
| 12 | 1558067199 | $7K |
| 13 | 1528653334 | $4K |
| 14 | 1760189898 | $1K |
| 15 | 1518366426 | $555 |
| 16 | Lsu Health Sciences Center Shreveport Faculty Group Practice Shreveport, LA · Oral & Maxillofacial Surgery | $83 |
| 17 | 1427595354 | $0 |
| 18 | 1851059588 | $0 |
| 19 | 1861137481 | $0 |
| 20 | 1639879034 | $0 |
Showing top 20 of 24 providers billing this code