81207
HCPCS Procedure Code
HCPCS code 81207 is the #3,611 most-billed Medicaid procedure code, with $1.4M in payments across 42K claims from 2018–2024. The national median cost per claim is $40.29. Costs vary widely — the 90th percentile is $93.49 per claim, 2.3× the median.
Total Paid
$1.4M
0.00% of all spending
Total Claims
42K
Providers
47
Avg Cost/Claim
$34
National Cost Distribution
How much do providers bill per claim for 81207? Based on 45 providers billing this code nationally.
Median
$40.29
Average
$48.91
Std Dev
$34.38
Max
$156.11
Percentile Distribution (Cost per Claim)
50% of providers bill between $24.78 and $66.18 per claim for this code.
90% bill between $9.83 and $93.49.
Top 1% bill above $140.71.
About This Procedure
HCPCS code 81207 was billed by 47 providers across 42K claims, totaling $1.4M in Medicaid payments from 2018–2024. This code was used for 39K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$40.29
Providers Billing
45
National Spending
$1.4M
Avg/Median Ratio
1.21×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 81207
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $303K |
| 2 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $169K |
| 3 | 1447437355 | $130K |
| 4 | 1013973866 | $125K |
| 5 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $96K |
| 6 | 1871615708 | $83K |
| 7 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $76K |
| 8 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $71K |
| 9 | Laboratory Corporation Of America San Diego, CA · Clinical Medical Laboratory | $54K |
| 10 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $43K |
| 11 | 1699115857 | $38K |
| 12 | 1124536107 | $35K |
| 13 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $28K |
| 14 | 1124269717 | $21K |
| 15 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $19K |
| 16 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $19K |
| 17 | 1780620526 | $14K |
| 18 | 1447296272 | $8K |
| 19 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $8K |
| 20 | Laboratory Corporation Of America Phoenix, AZ · Clinical Medical Laboratory | $8K |
Showing top 20 of 47 providers billing this code