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#3686 of 11K

81194

HCPCS Procedure Code

HCPCS code 81194 is the #3,686 most-billed Medicaid procedure code, with $1.3M in payments across 14K claims from 2018–2024. The national median cost per claim is $97.19. Costs vary widely — the 90th percentile is $208.16 per claim, 2.1× the median.

Total Paid

$1.3M

0.00% of all spending

Total Claims

14K

Providers

8

Avg Cost/Claim

$97

National Cost Distribution

How much do providers bill per claim for 81194? Based on 7 providers billing this code nationally.

Median

$97.19

Average

$123.69

Std Dev

$89.50

Max

$292.87

Percentile Distribution (Cost per Claim)

p10
$46.20
p25
$83.79
Median
$97.19
p75
$151.02
p90
$208.16
p95
$250.52
p99
$284.40

50% of providers bill between $83.79 and $151.02 per claim for this code.

90% bill between $46.20 and $208.16.

Top 1% bill above $284.40.

About This Procedure

HCPCS code 81194 was billed by 8 providers across 14K claims, totaling $1.3M in Medicaid payments from 2018–2024. This code was used for 13K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$97.19

Providers Billing

7

National Spending

$1.3M

Avg/Median Ratio

1.27×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81194

#ProviderTotal Paid
11013973866$980K
21740733708$294K
31730558602$22K
41780308262$20K
51447437355$8K
61447843750$6K
71528653334$508
81881334290$0

Showing top 8 of 8 providers billing this code