#1774 of 11K

82261

HCPCS Procedure Code

HCPCS code 82261 is the #1,774 most-billed Medicaid procedure code, with $14.2M in payments across 1.5M claims from 2018–2024. The national median cost per claim is $8.14. Costs vary widely — the 90th percentile is $18.06 per claim, 2.2× the median.

Total Paid

$14.2M

0.00% of all spending

Total Claims

1.5M

Providers

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for 82261? Based on 74 providers billing this code nationally.

Median

$8.14

Average

$21.75

Std Dev

$115.71

Max

$1,002.00

Percentile Distribution (Cost per Claim)

p10

$1.60

p25

$2.69

Median

$8.14

p75

$9.58

p90

$18.06

p95

$22.67

p99

$295.01

50% of providers bill between $2.69 and $9.58 per claim for this code.

90% bill between $1.60 and $18.06.

Top 1% bill above $295.01.

About This Procedure

HCPCS code 82261 was billed by 89 providers across 1.5M claims, totaling $14.2M in Medicaid payments from 2018–2024. This code was used for 1.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$8.14

Providers Billing

National Spending

$14.2M

Avg/Median Ratio

2.67×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 82261

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	State Of Alabama Department Of Public Health Prattville, AL · Clinical Medical Laboratory	$7.0M	$21.55	2.6× median	Top 10%
2	1942221098	$3.1M	$13.97	1.7× median	Above 75th
3	1477670529	$2.4M	$16.23	2.0× median	Above 75th
4	Bureau Of Public Health Laboratories Jacksonville, FL · Clinical Medical Laboratory	$1.1M	$1.60	0.2× median	Below Median
5	1346267424	$161K	$4.15	0.5× median	Below Median
6	1972575157	$50K	$8.17	1.0× median	Above Median
7	1386740587	$38K	$8.19	1.0× median	Above Median
8	1487697215	$37K	$14.50	1.8× median	Above 75th
9	1417016833	$29K	$2.68	0.3× median	Below Median
10	1528019189	$20K	$8.14	1.0× median	Above Median
11	1811130727	$17K	$10.56	1.3× median	Above 75th
12	1205829140	$17K	$8.15	1.0× median	Above Median
13	1164510673	$17K	$33.52	4.1× median	Top 10%
14	1831295880	$16K	$8.27	1.0× median	Above Median
15	1922055144	$16K	$7.81	1.0× median	Below Median
16	1801809322	$15K	$8.10	1.0× median	Below Median
17	Arrowhead Regional Medical Center Colton, CA · General Acute Care Hospital	$14K	$14.20	1.7× median	Above 75th
18	Vanderbilt University Medical Center Nashville, TN · Psychiatric Unit	$14K	$1,002.00	123.1× median	Top 1%
19	1235290651	$13K	$20.16	2.5× median	Top 10%
20	1780684670	$13K	$8.09	1.0× median	Below Median

Showing top 20 of 89 providers billing this code

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