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#8042 of 11K

81165

HCPCS Procedure Code

HCPCS code 81165 is the #8,042 most-billed Medicaid procedure code, with $7K in payments across 154 claims from 2018–2024. The national median cost per claim is $25.12. Costs vary widely — the 90th percentile is $186.06 per claim, 7.4× the median.

Total Paid

$7K

0.00% of all spending

Total Claims

154

Providers

3

Avg Cost/Claim

$44

National Cost Distribution

How much do providers bill per claim for 81165? Based on 3 providers billing this code nationally.

Median

$25.12

Average

$87.24

Std Dev

$120.65

Max

$226.30

Percentile Distribution (Cost per Claim)

p10
$13.28
p25
$17.72
Median
$25.12
p75
$125.71
p90
$186.06
p95
$206.18
p99
$222.28

50% of providers bill between $17.72 and $125.71 per claim for this code.

90% bill between $13.28 and $186.06.

Top 1% bill above $222.28.

About This Procedure

HCPCS code 81165 was billed by 3 providers across 154 claims, totaling $7K in Medicaid payments from 2018–2024. This code was used for 148 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$25.12

Providers Billing

3

National Spending

$7K

Avg/Median Ratio

3.47×

Highly skewed — outlier-driven

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.