#2619 of 11K

81400

HCPCS Procedure Code

HCPCS code 81400 is the #2,619 most-billed Medicaid procedure code, with $4.5M in payments across 459K claims from 2018–2024. The national median cost per claim is $14.64. Costs vary widely — the 90th percentile is $46.53 per claim, 3.2× the median.

Total Paid

$4.5M

0.00% of all spending

Total Claims

459K

Providers

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for 81400? Based on 73 providers billing this code nationally.

Median

$14.64

Average

$21.63

Std Dev

$18.54

Max

$80.68

Percentile Distribution (Cost per Claim)

p10

$2.94

p25

$8.16

Median

$14.64

p75

$36.76

p90

$46.53

p95

$53.30

p99

$69.14

50% of providers bill between $8.16 and $36.76 per claim for this code.

90% bill between $2.94 and $46.53.

Top 1% bill above $69.14.

About This Procedure

HCPCS code 81400 was billed by 94 providers across 459K claims, totaling $4.5M in Medicaid payments from 2018–2024. This code was used for 398K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$14.64

Providers Billing

National Spending

$4.5M

Avg/Median Ratio

1.48×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81400

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Natera Inc. San Carlos, CA · Clinical Medical Laboratory	$2.9M	$8.53	0.6× median	Below Median
2	1114222817	$412K	$18.33	1.3× median	Above Median
3	1235528225	$215K	$7.00	0.5× median	Below Median
4	Invitae Corporation San Francisco, CA · Clinical Medical Laboratory	$108K	$11.56	0.8× median	Below Median
5	1013973866	$97K	$11.59	0.8× median	Below Median
6	Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory	$94K	$37.00	2.5× median	Above 75th
7	1437585262	$88K	$52.35	3.6× median	Top 10%
8	1326484569	$81K	$14.06	1.0× median	Below Median
9	1518415991	$75K	$8.16	0.6× median	Below Median
10	New York City Health And Hospitals Corporation Elmhurst, NY · Internal Medicine	$51K	$44.46	3.0× median	Above 75th
11	1184045619	$42K	$8.64	0.6× median	Below Median
12	Sherman Abrams Laboratory Inc Brooklyn, NY · Clinical Medical Laboratory	$39K	$24.16	1.7× median	Above Median
13	Myriad Women's Health, Inc. South San Francisco, CA · Clinical Medical Laboratory	$33K	$12.38	0.8× median	Below Median
14	Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory	$29K	$33.99	2.3× median	Above Median
15	New York City Health And Hospitals Corporation Brooklyn, NY · Internal Medicine	$28K	$40.59	2.8× median	Above 75th
16	1124438528	$26K	$6.10	0.4× median	Below Median
17	New York City Health And Hospitals Corporation New York, NY · Internal Medicine	$25K	$44.11	3.0× median	Above 75th
18	1013924372	$23K	$44.75	3.1× median	Above 75th
19	1033124961	$22K	$43.36	3.0× median	Above 75th
20	1720409154	$17K	$12.39	0.8× median	Below Median

Showing top 20 of 94 providers billing this code

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