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#3979 of 11K

81442

HCPCS Procedure Code

HCPCS code 81442 is the #3,979 most-billed Medicaid procedure code, with $963K in payments across 6K claims from 2018–2024. The national median cost per claim is $216.29. Costs vary widely — the 90th percentile is $992.26 per claim, 4.6× the median.

Total Paid

$963K

0.00% of all spending

Total Claims

6K

Providers

11

Avg Cost/Claim

$156

National Cost Distribution

How much do providers bill per claim for 81442? Based on 6 providers billing this code nationally.

Median

$216.29

Average

$454.55

Std Dev

$422.77

Max

$1,088.29

Percentile Distribution (Cost per Claim)

p10
$155.10
p25
$200.57
Median
$216.29
p75
$729.03
p90
$992.26
p95
$1,040.27
p99
$1,078.69

50% of providers bill between $200.57 and $729.03 per claim for this code.

90% bill between $155.10 and $992.26.

Top 1% bill above $1,078.69.

About This Procedure

HCPCS code 81442 was billed by 11 providers across 6K claims, totaling $963K in Medicaid payments from 2018–2024. This code was used for 6K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$216.29

Providers Billing

6

National Spending

$963K

Avg/Median Ratio

2.10×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 81442

#ProviderTotal Paid
1Natera Inc.

San Carlos, CA · Clinical Medical Laboratory

$521K
21609388842$192K
3Invitae Corporation

San Francisco, CA · Clinical Medical Laboratory

$173K
41518039486$42K
5Genedx Llc

Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics

$32K
61861568784$3K
71467967745$0
81740715333$0
91255879763$0
101689264053$0
111245835594$0

Showing top 11 of 11 providers billing this code