#4715 of 11K

81050

HCPCS Procedure Code

HCPCS code 81050 is the #4,715 most-billed Medicaid procedure code, with $436K in payments across 201K claims from 2018–2024. The national median cost per claim is $2.00. Costs vary widely — the 90th percentile is $4.10 per claim, 2.0× the median.

Total Paid

$436K

0.00% of all spending

Total Claims

201K

Providers

159

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 81050? Based on 149 providers billing this code nationally.

Median

$2.00

Average

$2.41

Std Dev

$2.03

Max

$12.62

Percentile Distribution (Cost per Claim)

p10

$0.35

p25

$1.24

Median

$2.00

p75

$3.13

p90

$4.10

p95

$5.45

p99

$10.37

50% of providers bill between $1.24 and $3.13 per claim for this code.

90% bill between $0.35 and $4.10.

Top 1% bill above $10.37.

About This Procedure

HCPCS code 81050 was billed by 159 providers across 201K claims, totaling $436K in Medicaid payments from 2018–2024. This code was used for 178K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$2.00

Providers Billing

149

National Spending

$436K

Avg/Median Ratio

1.21×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81050

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1699849786	$186K	$2.38	1.2× median	Above Median
2	1083698534	$32K	$1.40	0.7× median	Below Median
3	Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory	$21K	$1.57	0.8× median	Below Median
4	Kaiser Foundation Health Plan Of The Northwest Portland, OR · General Practice	$18K	$9.45	4.7× median	Top 10%
5	Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory	$11K	$1.28	0.6× median	Below Median
6	1679660617	$11K	$8.88	4.4× median	Top 10%
7	1881697464	$9K	$3.69	1.8× median	Above 75th
8	Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory	$8K	$1.87	0.9× median	Below Median
9	1447255153	$8K	$7.12	3.6× median	Top 10%
10	1548208440	$7K	$2.29	1.1× median	Above Median
11	1922074434	$7K	$3.83	1.9× median	Above 75th
12	Multicare Health System Tacoma, WA · Community/Behavioral Health	$6K	$2.16	1.1× median	Above Median
13	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$6K	$2.82	1.4× median	Above Median
14	1083249577	$6K	$2.77	1.4× median	Above Median
15	Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory	$5K	$1.50	0.8× median	Below Median
16	Ohio State University Hospitals Columbus, OH · General Acute Care Hospital	$5K	$8.23	4.1× median	Top 10%
17	1710916945	$4K	$2.54	1.3× median	Above Median
18	Mid Atlantic Pemanente Medical Group Rockville, MD · Health Maintenance Organization	$4K	$4.52	2.3× median	Top 10%
19	St Elizabeth Medical Center, Inc Edgewood, KY · Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier	$4K	$2.92	1.5× median	Above Median
20	1699882738	$3K	$3.77	1.9× median	Above 75th

Showing top 20 of 159 providers billing this code

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