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#5868 of 11K

81191

HCPCS Procedure Code

HCPCS code 81191 is the #5,868 most-billed Medicaid procedure code, with $127K in payments across 5K claims from 2018–2024. The national median cost per claim is $12.10. Costs vary widely — the 90th percentile is $47.02 per claim, 3.9× the median.

Total Paid

$127K

0.00% of all spending

Total Claims

5K

Providers

11

Avg Cost/Claim

$23

National Cost Distribution

How much do providers bill per claim for 81191? Based on 10 providers billing this code nationally.

Median

$12.10

Average

$23.73

Std Dev

$32.17

Max

$108.57

Percentile Distribution (Cost per Claim)

p10
$3.57
p25
$7.26
Median
$12.10
p75
$26.04
p90
$47.02
p95
$77.80
p99
$102.42

50% of providers bill between $7.26 and $26.04 per claim for this code.

90% bill between $3.57 and $47.02.

Top 1% bill above $102.42.

About This Procedure

HCPCS code 81191 was billed by 11 providers across 5K claims, totaling $127K in Medicaid payments from 2018–2024. This code was used for 5K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.10

Providers Billing

10

National Spending

$127K

Avg/Median Ratio

1.96×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 81191

#ProviderTotal Paid
11740733708$48K
21013973866$35K
31457977209$24K
41447843750$13K
51528653334$3K
61760189898$3K
71275292294$571
81013525286$195
91134439573$187
101932843836$8
111881334290$0

Showing top 11 of 11 providers billing this code