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#4466 of 11K

81236

HCPCS Procedure Code

HCPCS code 81236 is the #4,466 most-billed Medicaid procedure code, with $571K in payments across 13K claims from 2018–2024. The national median cost per claim is $44.71. Costs vary widely — the 90th percentile is $171.09 per claim, 3.8× the median.

Total Paid

$571K

0.00% of all spending

Total Claims

13K

Providers

15

Avg Cost/Claim

$44

National Cost Distribution

How much do providers bill per claim for 81236? Based on 12 providers billing this code nationally.

Median

$44.71

Average

$72.61

Std Dev

$66.05

Max

$201.96

Percentile Distribution (Cost per Claim)

p10
$13.32
p25
$22.40
Median
$44.71
p75
$112.59
p90
$171.09
p95
$188.19
p99
$199.21

50% of providers bill between $22.40 and $112.59 per claim for this code.

90% bill between $13.32 and $171.09.

Top 1% bill above $199.21.

About This Procedure

HCPCS code 81236 was billed by 15 providers across 13K claims, totaling $571K in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$44.71

Providers Billing

12

National Spending

$571K

Avg/Median Ratio

1.62×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 81236

#ProviderTotal Paid
11013973866$325K
2Invitae Corporation

San Francisco, CA · Clinical Medical Laboratory

$198K
31639577091$20K
41457977209$10K
51447843750$8K
61548611593$3K
7Genedx Llc

Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics

$2K
81629109137$2K
91528653334$1K
101275292294$1K
11Laboratory Corporation Of America Holdings

Research Triangle Park, NC · Clinical Medical Laboratory

$1K
121932843836$11
131013525286$0
141881334290$0
151760189898$0

Showing top 15 of 15 providers billing this code