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#4559 of 11K

81328

HCPCS Procedure Code

HCPCS code 81328 is the #4,559 most-billed Medicaid procedure code, with $514K in payments across 28K claims from 2018–2024. The national median cost per claim is $13.69. Costs vary widely — the 90th percentile is $74.89 per claim, 5.5× the median.

Total Paid

$514K

0.00% of all spending

Total Claims

28K

Providers

91

Avg Cost/Claim

$18

National Cost Distribution

How much do providers bill per claim for 81328? Based on 50 providers billing this code nationally.

Median

$13.69

Average

$28.76

Std Dev

$37.40

Max

$143.88

Percentile Distribution (Cost per Claim)

p10
$1.74
p25
$5.65
Median
$13.69
p75
$28.47
p90
$74.89
p95
$125.78
p99
$139.65

50% of providers bill between $5.65 and $28.47 per claim for this code.

90% bill between $1.74 and $74.89.

Top 1% bill above $139.65.

About This Procedure

HCPCS code 81328 was billed by 91 providers across 28K claims, totaling $514K in Medicaid payments from 2018–2024. This code was used for 25K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.69

Providers Billing

50

National Spending

$514K

Avg/Median Ratio

2.10×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 81328

#ProviderTotal Paid
1Speciality Screening Llc

Wauwatosa, WI · Clinical Medical Laboratory

$75K
21821360017$54K
31124438528$45K
4Gravity Diagnostics, Llc

Covington, KY · Clinical Medical Laboratory

$44K
51760840482$25K
61497175905$23K
71639541295$23K
81275971707$21K
91467850859$21K
101437585262$18K
11Rca Laboratory Services, Llc

Glen Allen, VA · Clinical Medical Laboratory

$17K
121215272406$15K
131043271539$15K
141669836227$14K
151790023547$10K
16Crestar Labs Llc

Spring Hill, TN · Clinical Medical Laboratory

$9K
171922259753$9K
181427406776$8K
191720409154$8K
201184253650$7K

Showing top 20 of 91 providers billing this code