#1726 of 11K

81381

HCPCS Procedure Code

HCPCS code 81381 is the #1,726 most-billed Medicaid procedure code, with $15.2M in payments across 437K claims from 2018–2024. The national median cost per claim is $30.43. Costs vary widely — the 90th percentile is $88.59 per claim, 2.9× the median.

Total Paid

$15.2M

0.00% of all spending

Total Claims

437K

Providers

Avg Cost/Claim

$35

National Cost Distribution

How much do providers bill per claim for 81381? Based on 43 providers billing this code nationally.

Median

$30.43

Average

$39.85

Std Dev

$37.81

Max

$158.46

Percentile Distribution (Cost per Claim)

p10

$2.20

p25

$12.70

Median

$30.43

p75

$59.22

p90

$88.59

p95

$126.39

p99

$146.14

50% of providers bill between $12.70 and $59.22 per claim for this code.

90% bill between $2.20 and $88.59.

Top 1% bill above $146.14.

About This Procedure

HCPCS code 81381 was billed by 54 providers across 437K claims, totaling $15.2M in Medicaid payments from 2018–2024. This code was used for 364K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$30.43

Providers Billing

National Spending

$15.2M

Avg/Median Ratio

1.31×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81381

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1235363052	$13.5M	$35.06	1.2× median	Above Median
2	Millennium Health Llc San Diego, CA · Clinical Medical Laboratory	$423K	$56.25	1.8× median	Above Median
3	Unilab Corporation West Hills, CA · Clinical Medical Laboratory	$161K	$40.02	1.3× median	Above Median
4	Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory	$127K	$26.29	0.9× median	Below Median
5	1669836227	$127K	$67.98	2.2× median	Above 75th
6	1720409154	$121K	$92.62	3.0× median	Top 10%
7	1437135886	$92K	$20.73	0.7× median	Below Median
8	Mid Atlantic Pemanente Medical Group Rockville, MD · Health Maintenance Organization	$80K	$158.46	5.2× median	Top 1%
9	Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory	$78K	$41.43	1.4× median	Above Median
10	1447296272	$74K	$28.59	0.9× median	Below Median
11	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$74K	$30.43	1.0× median	Below Median
12	1124438528	$46K	$11.25	0.4× median	Below Median
13	Laboratory Corporation Of America San Diego, CA · Clinical Medical Laboratory	$37K	$45.40	1.5× median	Above Median
14	1740733708	$37K	$14.03	0.5× median	Below Median
15	1619980430	$28K	$72.44	2.4× median	Above 75th
16	1275971707	$26K	$13.24	0.4× median	Below Median
17	Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory	$22K	$70.68	2.3× median	Above 75th
18	1790021517	$20K	$62.19	2.0× median	Above 75th
19	Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory	$19K	$101.94	3.3× median	Top 10%
20	Unilab Corporation Sacramento, CA · Clinical Medical Laboratory	$17K	$39.99	1.3× median	Above Median

Showing top 20 of 54 providers billing this code

Related Procedures

81374$3.3M 81382$1.6M 81380$1.2M 81376$1.0M 81378$650K

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