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#2995 of 11K

81015

HCPCS Procedure Code

HCPCS code 81015 is the #2,995 most-billed Medicaid procedure code, with $2.8M in payments across 1.4M claims from 2018–2024. The national median cost per claim is $1.38. Costs vary widely — the 90th percentile is $3.82 per claim, 2.8× the median.

Total Paid

$2.8M

0.00% of all spending

Total Claims

1.4M

Providers

927

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for 81015? Based on 803 providers billing this code nationally.

Median

$1.38

Average

$2.66

Std Dev

$6.82

Max

$88.65

Percentile Distribution (Cost per Claim)

p10
$0.11
p25
$0.50
Median
$1.38
p75
$2.54
p90
$3.82
p95
$6.63
p99
$34.19

50% of providers bill between $0.50 and $2.54 per claim for this code.

90% bill between $0.11 and $3.82.

Top 1% bill above $34.19.

About This Procedure

HCPCS code 81015 was billed by 927 providers across 1.4M claims, totaling $2.8M in Medicaid payments from 2018–2024. This code was used for 1.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1.38

Providers Billing

803

National Spending

$2.8M

Avg/Median Ratio

1.93×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 81015

#ProviderTotal Paid
11831269539$596K
21679879589$123K
3Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$80K
41821147786$57K
51801861190$48K
6Maimonides Medical Center

Brooklyn, NY · General Acute Care Hospital

$47K
71780614685$46K
81861495335$42K
9Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$39K
10Quest Diagnostics Massachusetts Llc

Marlborough, MA · Clinical Medical Laboratory

$39K
111457345597$35K
121366431702$34K
131932146461$34K
141205307378$32K
151154361814$32K
161780677039$32K
17Spartanburg Medical Center

Spartanburg, SC · Ambulance

$31K
18Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$30K
19Alaska Native Tribal Health Consortium

Anchorage, AK · General Acute Care Hospital

$29K
201619038247$27K

Showing top 20 of 927 providers billing this code