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#3924 of 11K

81376

HCPCS Procedure Code

HCPCS code 81376 is the #3,924 most-billed Medicaid procedure code, with $1.0M in payments across 14K claims from 2018–2024. The national median cost per claim is $48.41. Costs vary widely — the 90th percentile is $166.83 per claim, 3.4× the median.

Total Paid

$1.0M

0.00% of all spending

Total Claims

14K

Providers

34

Avg Cost/Claim

$74

National Cost Distribution

How much do providers bill per claim for 81376? Based on 33 providers billing this code nationally.

Median

$48.41

Average

$80.27

Std Dev

$72.64

Max

$329.00

Percentile Distribution (Cost per Claim)

p10
$19.31
p25
$37.15
Median
$48.41
p75
$128.39
p90
$166.83
p95
$207.19
p99
$299.84

50% of providers bill between $37.15 and $128.39 per claim for this code.

90% bill between $19.31 and $166.83.

Top 1% bill above $299.84.

About This Procedure

HCPCS code 81376 was billed by 34 providers across 14K claims, totaling $1.0M in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$48.41

Providers Billing

33

National Spending

$1.0M

Avg/Median Ratio

1.66×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 81376

#ProviderTotal Paid
11881697464$234K
2Mayo Collaborative Services, Inc

Rochester, MN · Clinical Medical Laboratory

$171K
31083249577$115K
4Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$66K
51447296272$61K
61952546616$51K
7Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$46K
81972557064$40K
9Keck Medical Center Of Usc

Los Angeles, CA · General Acute Care Hospital

$32K
101225033020$29K
11Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$27K
12Henry Ford Health System

Detroit, MI · General Acute Care Hospital

$26K
13Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$21K
14Sunrise Medical Laboratories, Inc.

Hicksville, NY · Clinical Medical Laboratory

$20K
15University Of Cincinnati Medical Center, Llc

Cincinnati, OH · General Acute Care Hospital

$12K
16Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$10K
17Quest Diagnostics Clinical Laboratories Inc

Irving, TX · Clinical Medical Laboratory

$9K
18Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$8K
191639172372$6K
20Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$5K

Showing top 20 of 34 providers billing this code