81163
HCPCS Procedure Code
HCPCS code 81163 is the #3,321 most-billed Medicaid procedure code, with $1.9M in payments across 14K claims from 2018–2024. The national median cost per claim is $98.02. Costs vary widely — the 90th percentile is $276.45 per claim, 2.8× the median.
Total Paid
$1.9M
0.00% of all spending
Total Claims
14K
Providers
6
Avg Cost/Claim
$137
National Cost Distribution
How much do providers bill per claim for 81163? Based on 4 providers billing this code nationally.
Median
$98.02
Average
$140.37
Std Dev
$138.89
Max
$338.18
Percentile Distribution (Cost per Claim)
50% of providers bill between $54.55 and $183.85 per claim for this code.
90% bill between $38.18 and $276.45.
Top 1% bill above $332.01.
About This Procedure
HCPCS code 81163 was billed by 6 providers across 14K claims, totaling $1.9M in Medicaid payments from 2018–2024. This code was used for 13K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$98.02
Providers Billing
4
National Spending
$1.9M
Avg/Median Ratio
1.43×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 81163
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1013973866 | $1.8M |
| 2 | Myriad Genetic Laboratories, Inc. Salt Lake City, UT · Clinical Medical Laboratory | $133K |
| 3 | 1114222817 | $10K |
| 4 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $600 |
| 5 | 1730585456 | $0 |
| 6 | 1376645135 | $0 |
Showing top 6 of 6 providers billing this code