#3607 of 11K

81319

HCPCS Procedure Code

HCPCS code 81319 is the #3,607 most-billed Medicaid procedure code, with $1.4M in payments across 28K claims from 2018–2024. The national median cost per claim is $29.45. Costs vary widely — the 90th percentile is $120.35 per claim, 4.1× the median.

Total Paid

$1.4M

0.00% of all spending

Total Claims

28K

Providers

Avg Cost/Claim

$52

National Cost Distribution

How much do providers bill per claim for 81319? Based on 16 providers billing this code nationally.

Median

$29.45

Average

$45.87

Std Dev

$47.57

Max

$146.04

Percentile Distribution (Cost per Claim)

p10

$3.83

p25

$9.64

Median

$29.45

p75

$75.02

p90

$120.35

p95

$133.17

p99

$143.46

50% of providers bill between $9.64 and $75.02 per claim for this code.

90% bill between $3.83 and $120.35.

Top 1% bill above $143.46.

About This Procedure

HCPCS code 81319 was billed by 21 providers across 28K claims, totaling $1.4M in Medicaid payments from 2018–2024. This code was used for 25K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$29.45

Providers Billing

National Spending

$1.4M

Avg/Median Ratio

1.56×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 81319

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Myriad Genetic Laboratories, Inc. Salt Lake City, UT · Clinical Medical Laboratory	$504K	$74.86	2.5× median	Above Median
2	1316311863	$382K	$146.04	5.0× median	Top 1%
3	Invitae Corporation San Francisco, CA · Clinical Medical Laboratory	$183K	$17.79	0.6× median	Below Median
4	Speciality Screening Llc Wauwatosa, WI · Clinical Medical Laboratory	$160K	$111.81	3.8× median	Above 75th
5	1861568784	$97K	$45.57	1.5× median	Above Median
6	Bioconfirm Laboratories Llc Doraville, GA · Clinical Medical Laboratory	$63K	$33.85	1.1× median	Above Median
7	1639577091	$37K	$75.52	2.6× median	Above 75th
8	1649225632	$4K	$37.01	1.3× median	Above Median
9	1588004410	$3K	$128.88	4.4× median	Top 10%
10	1659726487	$2K	$9.87	0.3× median	Below Median
11	1518415991	$2K	$8.94	0.3× median	Below Median
12	Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory	$1K	$6.71	0.2× median	Below Median
13	1699172866	$977	$25.05	0.9× median	Below Median
14	1417407727	$365	$0.94	0.0× median	Below Median
15	1174009245	$172	$10.14	0.3× median	Below Median
16	1811484447	$163	$0.94	0.0× median	Below Median
17	1740715333	$0	$0.00	0.0× median	Below Median
18	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$0	$0.00	0.0× median	Below Median
19	1790023547	$0	$0.00	0.0× median	Below Median
20	1336598325	$0	$0.00	0.0× median	Below Median

Showing top 20 of 21 providers billing this code

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