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#2375 of 11K

81596

HCPCS Procedure Code

HCPCS code 81596 is the #2,375 most-billed Medicaid procedure code, with $6.3M in payments across 286K claims from 2018–2024. The national median cost per claim is $30.72. Costs vary widely — the 90th percentile is $72.92 per claim, 2.4× the median.

Total Paid

$6.3M

0.00% of all spending

Total Claims

286K

Providers

141

Avg Cost/Claim

$22

National Cost Distribution

How much do providers bill per claim for 81596? Based on 130 providers billing this code nationally.

Median

$30.72

Average

$38.70

Std Dev

$33.42

Max

$189.85

Percentile Distribution (Cost per Claim)

p10
$6.42
p25
$17.33
Median
$30.72
p75
$51.31
p90
$72.92
p95
$101.52
p99
$167.61

50% of providers bill between $17.33 and $51.31 per claim for this code.

90% bill between $6.42 and $72.92.

Top 1% bill above $167.61.

About This Procedure

HCPCS code 81596 was billed by 141 providers across 286K claims, totaling $6.3M in Medicaid payments from 2018–2024. This code was used for 271K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$30.72

Providers Billing

130

National Spending

$6.3M

Avg/Median Ratio

1.26×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81596

#ProviderTotal Paid
1Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$1.3M
2Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$487K
3Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$392K
4Quest Diagnostics Venture Llc

Pittsburgh, PA · Clinical Medical Laboratory

$344K
5Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$298K
61780620526$270K
7Labone Of Ohio Inc

Cincinnati, OH · Clinical Medical Laboratory

$262K
8Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$213K
9Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$198K
10Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$193K
11Quest Diagnostics Of Pennsylvania, Inc.

Pittsburgh, PA · Clinical Medical Laboratory

$184K
12Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$170K
13Laboratory Corporation Of America Holdings

Birmingham, AL · Clinical Medical Laboratory

$144K
14Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$128K
15Quest Diagnostics Clinical Laboratories Inc

Tucker, GA · Clinical Medical Laboratory

$113K
16Quest Diagnostics Massachusetts Llc

Marlborough, MA · Clinical Medical Laboratory

$94K
17Quest Diagnostics Llc Il

Wood Dale, IL · Clinical Medical Laboratory

$92K
181316983158$84K
19Unilab Corporation

Sacramento, CA · Clinical Medical Laboratory

$82K
20Quest Diagnostics Incorporated Md

Baltimore, MD · Clinical Medical Laboratory

$79K

Showing top 20 of 141 providers billing this code

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