81235
HCPCS Procedure Code
HCPCS code 81235 is the #3,275 most-billed Medicaid procedure code, with $2.1M in payments across 34K claims from 2018–2024. The national median cost per claim is $50.74. Costs vary widely — the 90th percentile is $170.26 per claim, 3.4× the median.
Total Paid
$2.1M
0.00% of all spending
Total Claims
34K
Providers
29
Avg Cost/Claim
$60
National Cost Distribution
How much do providers bill per claim for 81235? Based on 28 providers billing this code nationally.
Median
$50.74
Average
$70.29
Std Dev
$65.14
Max
$239.69
Percentile Distribution (Cost per Claim)
50% of providers bill between $22.70 and $88.89 per claim for this code.
90% bill between $15.22 and $170.26.
Top 1% bill above $233.88.
About This Procedure
HCPCS code 81235 was billed by 29 providers across 34K claims, totaling $2.1M in Medicaid payments from 2018–2024. This code was used for 30K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$50.74
Providers Billing
28
National Spending
$2.1M
Avg/Median Ratio
1.39×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 81235
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1013973866 | $1.1M |
| 2 | 1740733708 | $284K |
| 3 | 1184045619 | $263K |
| 4 | 1447437355 | $162K |
| 5 | 1952869612 | $58K |
| 6 | 1265714091 | $36K |
| 7 | 1508215922 | $28K |
| 8 | 1609388842 | $26K |
| 9 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $15K |
| 10 | 1982975421 | $13K |
| 11 | 1538559919 | $9K |
| 12 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $5K |
| 13 | Bioconfirm Laboratories Llc Doraville, GA · Clinical Medical Laboratory | $4K |
| 14 | 1871615708 | $4K |
| 15 | 1548611593 | $3K |
| 16 | 1659726487 | $3K |
| 17 | 1295019990 | $2K |
| 18 | 1871199760 | $2K |
| 19 | 1942474838 | $2K |
| 20 | 1528653334 | $1K |
Showing top 20 of 29 providers billing this code