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#4261 of 11K

81219

HCPCS Procedure Code

HCPCS code 81219 is the #4,261 most-billed Medicaid procedure code, with $706K in payments across 23K claims from 2018–2024. The national median cost per claim is $24.30. Costs vary widely — the 90th percentile is $90.64 per claim, 3.7× the median.

Total Paid

$706K

0.00% of all spending

Total Claims

23K

Providers

33

Avg Cost/Claim

$30

National Cost Distribution

How much do providers bill per claim for 81219? Based on 32 providers billing this code nationally.

Median

$24.30

Average

$33.79

Std Dev

$29.79

Max

$119.92

Percentile Distribution (Cost per Claim)

p10
$8.28
p25
$13.89
Median
$24.30
p75
$38.94
p90
$90.64
p95
$93.60
p99
$111.81

50% of providers bill between $13.89 and $38.94 per claim for this code.

90% bill between $8.28 and $90.64.

Top 1% bill above $111.81.

About This Procedure

HCPCS code 81219 was billed by 33 providers across 23K claims, totaling $706K in Medicaid payments from 2018–2024. This code was used for 22K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$24.30

Providers Billing

32

National Spending

$706K

Avg/Median Ratio

1.39×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81219

#ProviderTotal Paid
11447437355$155K
2Laboratory Corporation Of America Holdings

Research Triangle Park, NC · Clinical Medical Laboratory

$132K
3Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$110K
4Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$85K
51699115857$40K
6Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$26K
7Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$22K
8Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$20K
91396408829$20K
101780620526$15K
11Mid Atlantic Pemanente Medical Group

Rockville, MD · Health Maintenance Organization

$13K
12Permanente Medical Group, Inc.

Richmond, CA · Clinical Medical Laboratory

$12K
131447296272$9K
141467433292$9K
15Mayo Collaborative Services, Inc

Rochester, MN · Clinical Medical Laboratory

$7K
161871615708$6K
171811955917$6K
181124536107$5K
191740460583$3K
20Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$3K

Showing top 20 of 33 providers billing this code