Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#6638 of 11K

81192

HCPCS Procedure Code

HCPCS code 81192 is the #6,638 most-billed Medicaid procedure code, with $51K in payments across 2K claims from 2018–2024. The national median cost per claim is $13.65. Costs vary widely — the 90th percentile is $41.70 per claim, 3.1× the median.

Total Paid

$51K

0.00% of all spending

Total Claims

2K

Providers

13

Avg Cost/Claim

$24

National Cost Distribution

How much do providers bill per claim for 81192? Based on 9 providers billing this code nationally.

Median

$13.65

Average

$21.94

Std Dev

$33.32

Max

$108.57

Percentile Distribution (Cost per Claim)

p10
$1.55
p25
$7.21
Median
$13.65
p75
$15.59
p90
$41.70
p95
$75.14
p99
$101.88

50% of providers bill between $7.21 and $15.59 per claim for this code.

90% bill between $1.55 and $41.70.

Top 1% bill above $101.88.

About This Procedure

HCPCS code 81192 was billed by 13 providers across 2K claims, totaling $51K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.65

Providers Billing

9

National Spending

$51K

Avg/Median Ratio

1.61×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 81192

#ProviderTotal Paid
11457977209$24K
21013973866$17K
31447843750$6K
41528653334$3K
51275292294$571
61760189898$406
71013525286$195
81134439573$187
91932843836$8
101881334290$0
111942813050$0
121366820870$0
131427595354$0

Showing top 13 of 13 providers billing this code