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#4032 of 11K

81222

HCPCS Procedure Code

HCPCS code 81222 is the #4,032 most-billed Medicaid procedure code, with $914K in payments across 13K claims from 2018–2024. The national median cost per claim is $39.95. Costs vary widely — the 90th percentile is $192.75 per claim, 4.8× the median.

Total Paid

$914K

0.00% of all spending

Total Claims

13K

Providers

19

Avg Cost/Claim

$69

National Cost Distribution

How much do providers bill per claim for 81222? Based on 14 providers billing this code nationally.

Median

$39.95

Average

$81.17

Std Dev

$93.55

Max

$323.37

Percentile Distribution (Cost per Claim)

p10
$11.63
p25
$13.98
Median
$39.95
p75
$105.86
p90
$192.75
p95
$247.70
p99
$308.24

50% of providers bill between $13.98 and $105.86 per claim for this code.

90% bill between $11.63 and $192.75.

Top 1% bill above $308.24.

About This Procedure

HCPCS code 81222 was billed by 19 providers across 13K claims, totaling $914K in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$39.95

Providers Billing

14

National Spending

$914K

Avg/Median Ratio

2.03×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 81222

#ProviderTotal Paid
11326484569$659K
2Invitae Corporation

San Francisco, CA · Clinical Medical Laboratory

$66K
3Ohio State University Hospitals

Columbus, OH · General Acute Care Hospital

$48K
4St Josephs University Medical Center Inc.

Paterson, NJ · General Acute Care Hospital

$46K
51447436514$26K
6Mayo Collaborative Services, Inc

Rochester, MN · Clinical Medical Laboratory

$23K
7Laboratory Corporation Of America Holdings

Research Triangle Park, NC · Clinical Medical Laboratory

$22K
8Fulgent Therapeutics Llc.

El Monte, CA · Clinical Medical Laboratory

$19K
9Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$2K
10Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$1K
11Tricore Reference Laboratories

Albuquerque, NM · Clinical Medical Laboratory

$870
121568461572$558
131518713072$326
141275536799$286
15Laboratory Corporation Of America

Tampa, FL · Clinical Medical Laboratory

$0
161033270699$0
171285643304$0
181124170691$0
191043271539$0

Showing top 19 of 19 providers billing this code