81378
HCPCS Procedure Code
HCPCS code 81378 is the #4,342 most-billed Medicaid procedure code, with $650K in payments across 3K claims from 2018–2024. The national median cost per claim is $120.61. Costs vary widely — the 90th percentile is $401.05 per claim, 3.3× the median.
Total Paid
$650K
0.00% of all spending
Total Claims
3K
Providers
13
Avg Cost/Claim
$210
National Cost Distribution
How much do providers bill per claim for 81378? Based on 13 providers billing this code nationally.
Median
$120.61
Average
$190.42
Std Dev
$235.09
Max
$856.12
Percentile Distribution (Cost per Claim)
50% of providers bill between $38.54 and $230.90 per claim for this code.
90% bill between $21.51 and $401.05.
Top 1% bill above $804.03.
About This Procedure
HCPCS code 81378 was billed by 13 providers across 3K claims, totaling $650K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$120.61
Providers Billing
13
National Spending
$650K
Avg/Median Ratio
1.58×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 81378
| # | Provider | Total Paid |
|---|---|---|
| 1 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $262K |
| 2 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $233K |
| 3 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $58K |
| 4 | 1164493847 | $39K |
| 5 | 1497175905 | $22K |
| 6 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $16K |
| 7 | 1669430773 | $7K |
| 8 | Texas Children's Hospital Houston, TX · General Acute Care Hospital Children | $5K |
| 9 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $4K |
| 10 | 1699874248 | $2K |
| 11 | 1225033020 | $742 |
| 12 | 1548611593 | $723 |
| 13 | 1780653618 | $617 |
Showing top 13 of 13 providers billing this code