#558 of 11K

81162

HCPCS Procedure Code

HCPCS code 81162 is the #558 most-billed Medicaid procedure code, with $148.0M in payments across 231K claims from 2018–2024. The national median cost per claim is $484.02. Costs vary widely — the 90th percentile is $1,590.46 per claim, 3.3× the median.

Total Paid

$148.0M

0.01% of all spending

Total Claims

231K

Providers

Avg Cost/Claim

$640

National Cost Distribution

How much do providers bill per claim for 81162? Based on 60 providers billing this code nationally.

Median

$484.02

Average

$702.77

Std Dev

$589.58

Max

$1,803.55

Percentile Distribution (Cost per Claim)

p10

$45.51

p25

$150.31

Median

$484.02

p75

$1,181.24

p90

$1,590.46

p95

$1,771.89

p99

$1,803.50

50% of providers bill between $150.31 and $1,181.24 per claim for this code.

90% bill between $45.51 and $1,590.46.

Top 1% bill above $1,803.50.

About This Procedure

HCPCS code 81162 was billed by 81 providers across 231K claims, totaling $148.0M in Medicaid payments from 2018–2024. This code was used for 211K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$484.02

Providers Billing

National Spending

$148.0M

Avg/Median Ratio

1.45×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81162

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Myriad Genetic Laboratories, Inc. Salt Lake City, UT · Clinical Medical Laboratory	$71.9M	$894.09	1.8× median	Above Median
2	Invitae Corporation San Francisco, CA · Clinical Medical Laboratory	$34.1M	$441.72	0.9× median	Below Median
3	1861568784	$20.9M	$640.63	1.3× median	Above Median
4	Unilab Corporation West Hills, CA · Clinical Medical Laboratory	$3.6M	$848.05	1.8× median	Above Median
5	Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory	$3.2M	$542.04	1.1× median	Above Median
6	Natera Inc. San Carlos, CA · Clinical Medical Laboratory	$3.0M	$269.86	0.6× median	Below Median
7	1790023547	$2.6M	$1,116.77	2.3× median	Above Median
8	1649225632	$1.1M	$1,578.89	3.3× median	Above 75th
9	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$825K	$1,569.28	3.2× median	Above 75th
10	Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics	$730K	$468.09	1.0× median	Below Median
11	1740733708	$715K	$404.83	0.8× median	Below Median
12	Bioconfirm Laboratories Llc Doraville, GA · Clinical Medical Laboratory	$641K	$314.47	0.6× median	Below Median
13	1811932940	$527K	$1,732.39	3.6× median	Top 10%
14	1700512365	$459K	$909.18	1.9× median	Above Median
15	Speciality Screening Llc Wauwatosa, WI · Clinical Medical Laboratory	$451K	$1,694.56	3.5× median	Top 10%
16	1316311863	$416K	$1,409.82	2.9× median	Above 75th
17	1750373908	$319K	$1,169.37	2.4× median	Above Median
18	1457977209	$293K	$1,178.47	2.4× median	Above Median
19	Unilab Corporation Sacramento, CA · Clinical Medical Laboratory	$290K	$1,803.46	3.7× median	Top 10%
20	1629109137	$262K	$1,130.12	2.3× median	Above Median

Showing top 20 of 81 providers billing this code

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