#4937 of 11K

81338

HCPCS Procedure Code

HCPCS code 81338 is the #4,937 most-billed Medicaid procedure code, with $347K in payments across 9K claims from 2018–2024. The national median cost per claim is $34.64. Costs vary widely — the 90th percentile is $112.04 per claim, 3.2× the median.

Total Paid

$347K

0.00% of all spending

Total Claims

Providers

Avg Cost/Claim

$41

National Cost Distribution

How much do providers bill per claim for 81338? Based on 17 providers billing this code nationally.

Median

$34.64

Average

$43.98

Std Dev

$40.50

Max

$134.39

Percentile Distribution (Cost per Claim)

p10

$2.23

p25

$22.59

Median

$34.64

p75

$45.80

p90

$112.04

p95

$128.88

p99

$133.29

50% of providers bill between $22.59 and $45.80 per claim for this code.

90% bill between $2.23 and $112.04.

Top 1% bill above $133.29.

About This Procedure

HCPCS code 81338 was billed by 18 providers across 9K claims, totaling $347K in Medicaid payments from 2018–2024. This code was used for 8K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$34.64

Providers Billing

National Spending

$347K

Avg/Median Ratio

1.27×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81338

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory	$127K	$45.80	1.3× median	Above 75th
2	1699115857	$75K	$33.74	1.0× median	Below Median
3	Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory	$53K	$34.64	1.0× median	Above Median
4	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$32K	$43.62	1.3× median	Above Median
5	Permanente Medical Group, Inc. Richmond, CA · Clinical Medical Laboratory	$19K	$134.39	3.9× median	Top 1%
6	Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory	$18K	$101.74	2.9× median	Above 75th
7	1467433292	$9K	$48.14	1.4× median	Above 75th
8	1740460583	$4K	$127.51	3.7× median	Top 10%
9	1811955917	$3K	$45.32	1.3× median	Above Median
10	1841375094	$2K	$11.69	0.3× median	Below Median
11	1720306566	$2K	$25.36	0.7× median	Below Median
12	Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory	$1K	$43.34	1.3× median	Above Median
13	Siparadigm Llc Pine Brook, NJ · Clinical Medical Laboratory	$644	$23.85	0.7× median	Below Median
14	Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory	$316	$22.59	0.7× median	Below Median
15	1942226006	$275	$2.35	0.1× median	Below Median
16	1871615708	$162	$2.06	0.1× median	Below Median
17	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$117	$1.51	0.0× median	Below Median
18	1760076061	$0	$0.00	0.0× median	Below Median

Showing top 18 of 18 providers billing this code

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