81416
Exome sequence analysis
Exome sequence analysis is the #666 most-billed Medicaid procedure code, with $111.2M in payments across 50K claims from 2018–2024. The national median cost per claim is $1,030.45. Costs vary widely — the 90th percentile is $3,320.11 per claim, 3.2× the median.
Total Paid
$111.2M
0.01% of all spending
Total Claims
50K
Providers
11
Avg Cost/Claim
$2K
National Cost Distribution
How much do providers bill per claim for 81416? Based on 11 providers billing this code nationally.
Median
$1,030.45
Average
$2,114.71
Std Dev
$2,782.91
Max
$9,664.40
Percentile Distribution (Cost per Claim)
50% of providers bill between $305.96 and $2,767.25 per claim for this code.
90% bill between $113.80 and $3,320.11.
Top 1% bill above $9,029.97.
About This Procedure
HCPCS code 81416 (Exome sequence analysis) was billed by 11 providers across 50K claims, totaling $111.2M in Medicaid payments from 2018–2024. This code was used for 46K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$1,030.45
Providers Billing
11
National Spending
$111.2M
Avg/Median Ratio
2.05×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 81416
| # | Provider | Total Paid |
|---|---|---|
| 1 | Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics | $105.8M |
| 2 | 1629512140 | $2.6M |
| 3 | 1861568784 | $2.0M |
| 4 | 1699095901 | $325K |
| 5 | 1043414113 | $246K |
| 6 | Seattle Children's Hospital Seattle, WA · Prosthetic/Orthotic Supplier | $132K |
| 7 | Vanderbilt University Medical Center Nashville, TN · Psychiatric Unit | $126K |
| 8 | Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children | $39K |
| 9 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $9K |
| 10 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $7K |
| 11 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $3K |
Showing top 11 of 11 providers billing this code