81401
HCPCS Procedure Code
HCPCS code 81401 is the #1,787 most-billed Medicaid procedure code, with $13.9M in payments across 588K claims from 2018–2024. The national median cost per claim is $30.88. Costs vary widely — the 90th percentile is $116.60 per claim, 3.8× the median.
Total Paid
$13.9M
0.00% of all spending
Total Claims
588K
Providers
239
Avg Cost/Claim
$24
National Cost Distribution
How much do providers bill per claim for 81401? Based on 188 providers billing this code nationally.
Median
$30.88
Average
$49.78
Std Dev
$64.10
Max
$662.66
Percentile Distribution (Cost per Claim)
50% of providers bill between $11.85 and $68.22 per claim for this code.
90% bill between $2.96 and $116.60.
Top 1% bill above $201.50.
About This Procedure
HCPCS code 81401 was billed by 239 providers across 588K claims, totaling $13.9M in Medicaid payments from 2018–2024. This code was used for 509K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$30.88
Providers Billing
188
National Spending
$13.9M
Avg/Median Ratio
1.61×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 81401
| # | Provider | Total Paid |
|---|---|---|
| 1 | Natera Inc. San Carlos, CA · Clinical Medical Laboratory | $5.1M |
| 2 | 1114222817 | $881K |
| 3 | 1689975021 | $709K |
| 4 | 1013973866 | $636K |
| 5 | 1235528225 | $631K |
| 6 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $373K |
| 7 | Speciality Screening Llc Wauwatosa, WI · Clinical Medical Laboratory | $331K |
| 8 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $271K |
| 9 | 1235363052 | $210K |
| 10 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $204K |
| 11 | Myriad Women's Health, Inc. South San Francisco, CA · Clinical Medical Laboratory | $198K |
| 12 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $196K |
| 13 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $174K |
| 14 | 1518415991 | $166K |
| 15 | 1679507594 | $166K |
| 16 | Laboratory Corporation Of America San Diego, CA · Clinical Medical Laboratory | $147K |
| 17 | 1184045619 | $144K |
| 18 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $139K |
| 19 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $133K |
| 20 | 1437585262 | $130K |
Showing top 20 of 239 providers billing this code