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#4575 of 11K

81370

HCPCS Procedure Code

HCPCS code 81370 is the #4,575 most-billed Medicaid procedure code, with $508K in payments across 3K claims from 2018–2024. The national median cost per claim is $205.10. Costs vary widely — the 90th percentile is $621.35 per claim, 3.0× the median.

Total Paid

$508K

0.00% of all spending

Total Claims

3K

Providers

20

Avg Cost/Claim

$183

National Cost Distribution

How much do providers bill per claim for 81370? Based on 18 providers billing this code nationally.

Median

$205.10

Average

$358.75

Std Dev

$608.84

Max

$2,627.17

Percentile Distribution (Cost per Claim)

p10
$33.30
p25
$59.33
Median
$205.10
p75
$340.94
p90
$621.35
p95
$1,196.94
p99
$2,341.12

50% of providers bill between $59.33 and $340.94 per claim for this code.

90% bill between $33.30 and $621.35.

Top 1% bill above $2,341.12.

About This Procedure

HCPCS code 81370 was billed by 20 providers across 3K claims, totaling $508K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$205.10

Providers Billing

18

National Spending

$508K

Avg/Median Ratio

1.75×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 81370

#ProviderTotal Paid
11225033020$130K
2Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$98K
3The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$73K
4Ohio State University Hospitals

Columbus, OH · General Acute Care Hospital

$65K
51154392231$32K
6Henry Ford Health System

Detroit, MI · General Acute Care Hospital

$31K
71639172372$27K
8Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$20K
9Inova Health Care Services

Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder

$6K
101083249577$5K
11Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$5K
12Medical University Hospital Authority

Charleston, SC · General Acute Care Hospital

$4K
13Oregon Health & Science University

Portland, OR · General Practice

$3K
14Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$3K
15Tufts Medical Center, Inc.

Boston, MA · General Acute Care Hospital

$2K
161992703540$2K
171457354656$1K
18State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$907
19University Of Washington

Seattle, WA · Clinic/Center, Dental

$0
20Brigham & Womens Hospital Inc.

Boston, MA · General Acute Care Hospital

$0

Showing top 20 of 20 providers billing this code