81189
HCPCS Procedure Code
HCPCS code 81189 is the #5,529 most-billed Medicaid procedure code, with $181K in payments across 3K claims from 2018–2024. The national median cost per claim is $13.20. Costs vary widely — the 90th percentile is $69.08 per claim, 5.2× the median.
Total Paid
$181K
0.00% of all spending
Total Claims
3K
Providers
14
Avg Cost/Claim
$65
National Cost Distribution
How much do providers bill per claim for 81189? Based on 10 providers billing this code nationally.
Median
$13.20
Average
$32.67
Std Dev
$51.23
Max
$169.83
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.75 and $31.53 per claim for this code.
90% bill between $2.69 and $69.08.
Top 1% bill above $159.76.
About This Procedure
HCPCS code 81189 was billed by 14 providers across 3K claims, totaling $181K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$13.20
Providers Billing
10
National Spending
$181K
Avg/Median Ratio
2.48×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 81189
| # | Provider | Total Paid |
|---|---|---|
| 1 | Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics | $114K |
| 2 | 1457977209 | $64K |
| 3 | 1528653334 | $1K |
| 4 | 1275292294 | $756 |
| 5 | 1013525286 | $528 |
| 6 | 1134439573 | $468 |
| 7 | 1760189898 | $269 |
| 8 | 1770207607 | $220 |
| 9 | 1871169706 | $218 |
| 10 | 1932843836 | $11 |
| 11 | 1518366426 | $0 |
| 12 | 1851059588 | $0 |
| 13 | 1447843750 | $0 |
| 14 | 1881334290 | $0 |
Showing top 14 of 14 providers billing this code