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#3707 of 11K

81364

HCPCS Procedure Code

HCPCS code 81364 is the #3,707 most-billed Medicaid procedure code, with $1.3M in payments across 24K claims from 2018–2024. The national median cost per claim is $68.32. Costs vary widely — the 90th percentile is $192.57 per claim, 2.8× the median.

Total Paid

$1.3M

0.00% of all spending

Total Claims

24K

Providers

21

Avg Cost/Claim

$55

National Cost Distribution

How much do providers bill per claim for 81364? Based on 19 providers billing this code nationally.

Median

$68.32

Average

$94.90

Std Dev

$83.18

Max

$309.39

Percentile Distribution (Cost per Claim)

p10
$24.30
p25
$35.01
Median
$68.32
p75
$119.58
p90
$192.57
p95
$286.88
p99
$304.89

50% of providers bill between $35.01 and $119.58 per claim for this code.

90% bill between $24.30 and $192.57.

Top 1% bill above $304.89.

About This Procedure

HCPCS code 81364 was billed by 21 providers across 24K claims, totaling $1.3M in Medicaid payments from 2018–2024. This code was used for 21K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$68.32

Providers Billing

19

National Spending

$1.3M

Avg/Median Ratio

1.39×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81364

#ProviderTotal Paid
1Natera Inc.

San Carlos, CA · Clinical Medical Laboratory

$411K
21790023547$335K
31326484569$97K
41447436514$81K
5Myriad Women's Health, Inc.

South San Francisco, CA · Clinical Medical Laboratory

$77K
6Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$56K
7Laboratory Corporation Of America Holdings

Research Triangle Park, NC · Clinical Medical Laboratory

$54K
8Speciality Screening Llc

Wauwatosa, WI · Clinical Medical Laboratory

$53K
9Laboratory Corporation Of America

Tampa, FL · Clinical Medical Laboratory

$40K
101457977209$38K
11Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$15K
12Invitae Corporation

San Francisco, CA · Clinical Medical Laboratory

$15K
131780620526$7K
14Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$7K
151063892396$5K
161689975021$5K
17Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$4K
18Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$3K
19Laboratory Corporation Of America

San Diego, CA · Clinical Medical Laboratory

$234
201770207607$0

Showing top 20 of 21 providers billing this code