81407
HCPCS Procedure Code
HCPCS code 81407 is the #1,802 most-billed Medicaid procedure code, with $13.6M in payments across 110K claims from 2018–2024. The national median cost per claim is $98.12. Costs vary widely — the 90th percentile is $642.65 per claim, 6.5× the median.
Total Paid
$13.6M
0.00% of all spending
Total Claims
110K
Providers
70
Avg Cost/Claim
$123
National Cost Distribution
How much do providers bill per claim for 81407? Based on 42 providers billing this code nationally.
Median
$98.12
Average
$218.59
Std Dev
$378.78
Max
$2,164.77
Percentile Distribution (Cost per Claim)
50% of providers bill between $23.96 and $204.85 per claim for this code.
90% bill between $5.92 and $642.65.
Top 1% bill above $1,598.99.
About This Procedure
HCPCS code 81407 was billed by 70 providers across 110K claims, totaling $13.6M in Medicaid payments from 2018–2024. This code was used for 99K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$98.12
Providers Billing
42
National Spending
$13.6M
Avg/Median Ratio
2.23×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 81407
| # | Provider | Total Paid |
|---|---|---|
| 1 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $3.5M |
| 2 | 1316311863 | $1.9M |
| 3 | Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics | $1.8M |
| 4 | Speciality Screening Llc Wauwatosa, WI · Clinical Medical Laboratory | $1.6M |
| 5 | Natera Inc. San Carlos, CA · Clinical Medical Laboratory | $1.3M |
| 6 | 1013973866 | $1.1M |
| 7 | 1790023547 | $891K |
| 8 | 1518415991 | $450K |
| 9 | 1861568784 | $336K |
| 10 | 1326484569 | $222K |
| 11 | Sherman Abrams Laboratory Inc Brooklyn, NY · Clinical Medical Laboratory | $90K |
| 12 | 1629109137 | $64K |
| 13 | The Children's Mercy Hospital Kansas City, MO · General Acute Care Hospital Children | $63K |
| 14 | 1518713072 | $58K |
| 15 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $50K |
| 16 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $47K |
| 17 | 1366820870 | $32K |
| 18 | 1114222817 | $17K |
| 19 | 1447843750 | $12K |
| 20 | Myriad Women's Health, Inc. South San Francisco, CA · Clinical Medical Laboratory | $11K |
Showing top 20 of 70 providers billing this code