#1738 of 11K

81211

HCPCS Procedure Code

HCPCS code 81211 is the #1,738 most-billed Medicaid procedure code, with $15.1M in payments across 19K claims from 2018–2024. The national median cost per claim is $297.52. Costs vary widely — the 90th percentile is $1,193.05 per claim, 4.0× the median.

Total Paid

$15.1M

0.00% of all spending

Total Claims

19K

Providers

Avg Cost/Claim

$791

National Cost Distribution

How much do providers bill per claim for 81211? Based on 18 providers billing this code nationally.

Median

$297.52

Average

$517.15

Std Dev

$512.08

Max

$1,765.50

Percentile Distribution (Cost per Claim)

p10

$26.67

p25

$79.72

Median

$297.52

p75

$691.94

p90

$1,193.05

p95

$1,294.57

p99

$1,671.31

50% of providers bill between $79.72 and $691.94 per claim for this code.

90% bill between $26.67 and $1,193.05.

Top 1% bill above $1,671.31.

About This Procedure

HCPCS code 81211 was billed by 22 providers across 19K claims, totaling $15.1M in Medicaid payments from 2018–2024. This code was used for 16K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$297.52

Providers Billing

National Spending

$15.1M

Avg/Median Ratio

1.74×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 81211

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Myriad Genetic Laboratories, Inc. Salt Lake City, UT · Clinical Medical Laboratory	$10.2M	$1,090.50	3.7× median	Above 75th
2	1861568784	$1.6M	$698.61	2.3× median	Above 75th
3	1790023547	$1.3M	$1,765.50	5.9× median	Top 1%
4	Invitae Corporation San Francisco, CA · Clinical Medical Laboratory	$1.1M	$300.52	1.0× median	Above Median
5	1013973866	$260K	$247.88	0.8× median	Below Median
6	Myriad Women's Health, Inc. South San Francisco, CA · Clinical Medical Laboratory	$146K	$671.94	2.3× median	Above Median
7	Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory	$117K	$658.73	2.2× median	Above Median
8	1629109137	$93K	$1,211.46	4.1× median	Top 10%
9	1508215922	$86K	$294.51	1.0× median	Below Median
10	1265714091	$86K	$289.19	1.0× median	Below Median
11	1750373908	$63K	$1,185.16	4.0× median	Above 75th
12	Bioconfirm Laboratories Llc Doraville, GA · Clinical Medical Laboratory	$38K	$614.42	2.1× median	Above Median
13	1316370950	$18K	$69.05	0.2× median	Below Median
14	1760521611	$5K	$111.73	0.4× median	Below Median
15	1639577091	$4K	$25.94	0.1× median	Below Median
16	1336598325	$3K	$26.98	0.1× median	Below Median
17	1376645135	$2K	$39.00	0.1× median	Below Median
18	1699287300	$931	$7.51	0.0× median	Below Median
19	1700329901	$0	$0.00	0.0× median	Below Median
20	1356783344	$0	$0.00	0.0× median	Below Median

Showing top 20 of 22 providers billing this code

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