#335 of 11K

81479

Unlisted molecular pathology procedure

Unlisted molecular pathology procedure is the #335 most-billed Medicaid procedure code, with $399.7M in payments across 2.5M claims from 2018–2024. The national median cost per claim is $38.66. Costs vary widely — the 90th percentile is $273.42 per claim, 7.1× the median.

Total Paid

$399.7M

0.04% of all spending

Total Claims

2.5M

Providers

259

Avg Cost/Claim

$160

National Cost Distribution

How much do providers bill per claim for 81479? Based on 194 providers billing this code nationally.

Median

$38.66

Average

$122.74

Std Dev

$264.67

Max

$2,333.02

Percentile Distribution (Cost per Claim)

p10

$1.31

p25

$8.02

Median

$38.66

p75

$128.43

p90

$273.42

p95

$501.28

p99

$1,451.85

50% of providers bill between $8.02 and $128.43 per claim for this code.

90% bill between $1.31 and $273.42.

Top 1% bill above $1,451.85.

About This Procedure

HCPCS code 81479 (Unlisted molecular pathology procedure) was billed by 259 providers across 2.5M claims, totaling $399.7M in Medicaid payments from 2018–2024. This code was used for 1.7M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$38.66

Providers Billing

194

National Spending

$399.7M

Avg/Median Ratio

3.17×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 81479

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	State Of Alabama Department Of Public Health Prattville, AL · Clinical Medical Laboratory	$267.7M	$1,609.34	41.6× median	Top 1%
2	Bureau Of Public Health Laboratories Jacksonville, FL · Clinical Medical Laboratory	$33.7M	$51.22	1.3× median	Above Median
3	1235363052	$17.6M	$46.41	1.2× median	Above Median
4	Invitae Corporation San Francisco, CA · Clinical Medical Laboratory	$13.1M	$269.41	7.0× median	Above 75th
5	Natera Inc. San Carlos, CA · Clinical Medical Laboratory	$12.1M	$278.15	7.2× median	Top 10%
6	Myriad Genetic Laboratories, Inc. Salt Lake City, UT · Clinical Medical Laboratory	$11.2M	$127.03	3.3× median	Above Median
7	1861568784	$8.4M	$833.83	21.6× median	Top 10%
8	1689607384	$5.8M	$115.28	3.0× median	Above Median
9	1013973866	$4.6M	$218.16	5.6× median	Above 75th
10	Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics	$3.2M	$199.16	5.2× median	Above 75th
11	1306875877	$2.4M	$2,333.02	60.3× median	Top 1%
12	1598314437	$2.2M	$185.54	4.8× median	Above 75th
13	Myriad Women's Health, Inc. South San Francisco, CA · Clinical Medical Laboratory	$1.8M	$61.16	1.6× median	Above Median
14	1942221098	$1.5M	$9.05	0.2× median	Below Median
15	1184045619	$1.4M	$169.60	4.4× median	Above 75th
16	1477670529	$1.2M	$8.06	0.2× median	Below Median
17	1730481078	$1.2M	$113.04	2.9× median	Above Median
18	1508105024	$958K	$172.77	4.5× median	Above 75th
19	Speciality Screening Llc Wauwatosa, WI · Clinical Medical Laboratory	$908K	$352.78	9.1× median	Top 10%
20	1467850859	$635K	$2.20	0.1× median	Below Median

Showing top 20 of 259 providers billing this code

Related Procedures

81470$1.9M 81471$1.6M

← All procedures Top providers →