81426
HCPCS Procedure Code
HCPCS code 81426 is the #3,283 most-billed Medicaid procedure code, with $2.0M in payments across 2K claims from 2018–2024. The national median cost per claim is $409.74. Costs vary widely — the 90th percentile is $1,283.75 per claim, 3.1× the median.
Total Paid
$2.0M
0.00% of all spending
Total Claims
2K
Providers
5
Avg Cost/Claim
$1K
National Cost Distribution
How much do providers bill per claim for 81426? Based on 5 providers billing this code nationally.
Median
$409.74
Average
$657.11
Std Dev
$561.70
Max
$1,467.07
Percentile Distribution (Cost per Claim)
50% of providers bill between $240.09 and $1,008.76 per claim for this code.
90% bill between $191.97 and $1,283.75.
Top 1% bill above $1,448.74.
About This Procedure
HCPCS code 81426 was billed by 5 providers across 2K claims, totaling $2.0M in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$409.74
Providers Billing
5
National Spending
$2.0M
Avg/Median Ratio
1.60×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 81426
| # | Provider | Total Paid |
|---|---|---|
| 1 | Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics | $1.0M |
| 2 | 1629512140 | $954K |
| 3 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $15K |
| 4 | 1568860062 | $10K |
| 5 | Seattle Children's Hospital Seattle, WA · Prosthetic/Orthotic Supplier | $9K |
Showing top 5 of 5 providers billing this code