81245
HCPCS Procedure Code
HCPCS code 81245 is the #5,947 most-billed Medicaid procedure code, with $115K in payments across 4,023 claims from 2018–2024. The national median cost per claim is $25.72. Costs vary widely — the 90th percentile is $51.55 per claim, 2.0× the median.
Total Paid
$115K
0.00% of all spending
Total Claims
4,023
Providers
6
Avg Cost/Claim
$29
National Cost Distribution
How much do providers bill per claim for 81245? Based on 6 providers billing this code nationally.
Median
$25.72
Average
$32.75
Std Dev
$19.25
Max
$70.83
Percentile Distribution (Cost per Claim)
50% of providers bill between $22.22 and $31.50 per claim for this code.
90% bill between $20.99 and $51.55.
Top 1% bill above $68.90.
About This Procedure
HCPCS code 81245 was billed by 6 providers across 4,023 claims, totaling $115K in Medicaid payments from 2018–2024. This code was used for 3,619 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$25.72
Providers Billing
6
National Spending
$115K
Avg/Median Ratio
1.27×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 81245
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1013973866 | $79K |
| 2 | 1265714091 | $21K |
| 3 | 1508215922 | $13K |
| 4 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $850 |
| 5 | 1447437355 | $731 |
| 6 | 1740733708 | $533 |
Showing top 6 of 6 providers billing this code