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#308 of 11K

81220

CFTR gene analysis, common variants

CFTR gene analysis, common variants is the #308 most-billed Medicaid procedure code, with $458.2M in payments across 2.5M claims from 2018–2024. The national median cost per claim is $183.31. Costs vary widely — the 90th percentile is $421.84 per claim, 2.3× the median.

Total Paid

$458.2M

0.04% of all spending

Total Claims

2.5M

Providers

502

Avg Cost/Claim

$187

National Cost Distribution

How much do providers bill per claim for 81220? Based on 448 providers billing this code nationally.

Median

$183.31

Average

$213.22

Std Dev

$179.67

Max

$1,837.21

Percentile Distribution (Cost per Claim)

p10
$24.23
p25
$87.01
Median
$183.31
p75
$300.45
p90
$421.84
p95
$481.01
p99
$847.37

50% of providers bill between $87.01 and $300.45 per claim for this code.

90% bill between $24.23 and $421.84.

Top 1% bill above $847.37.

About This Procedure

HCPCS code 81220 (CFTR gene analysis, common variants) was billed by 502 providers across 2.5M claims, totaling $458.2M in Medicaid payments from 2018–2024. This code was used for 2.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$183.31

Providers Billing

448

National Spending

$458.2M

Avg/Median Ratio

1.16×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81220

#ProviderTotal Paid
1Natera Inc.

San Carlos, CA · Clinical Medical Laboratory

$74.6M
2Myriad Women's Health, Inc.

South San Francisco, CA · Clinical Medical Laboratory

$35.3M
31689975021$32.0M
4Laboratory Corporation Of America Holdings

Research Triangle Park, NC · Clinical Medical Laboratory

$31.6M
51598314437$22.3M
6Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$22.1M
7Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$14.6M
8State Of Alabama Department Of Public Health

Prattville, AL · Clinical Medical Laboratory

$11.3M
9Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$10.4M
10Invitae Corporation

San Francisco, CA · Clinical Medical Laboratory

$10.0M
111114222817$9.7M
12Bureau Of Public Health Laboratories

Jacksonville, FL · Clinical Medical Laboratory

$9.6M
131235528225$7.7M
14Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$7.6M
15Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$7.3M
16Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$7.1M
17Laboratory Corporation Of America

Tampa, FL · Clinical Medical Laboratory

$7.1M
18Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$6.5M
191780620526$6.5M
20Unilab Corporation

Sacramento, CA · Clinical Medical Laboratory

$6.0M

Showing top 20 of 502 providers billing this code