81249
HCPCS Procedure Code
HCPCS code 81249 is the #4,025 most-billed Medicaid procedure code, with $919K in payments across 8,460 claims from 2018–2024. The national median cost per claim is $111.06. Costs vary widely — the 90th percentile is $520.57 per claim, 4.7× the median.
Total Paid
$919K
0.00% of all spending
Total Claims
8,460
Providers
33
Avg Cost/Claim
$109
National Cost Distribution
How much do providers bill per claim for 81249? Based on 16 providers billing this code nationally.
Median
$111.06
Average
$205.07
Std Dev
$201.21
Max
$558.96
Percentile Distribution (Cost per Claim)
50% of providers bill between $47.89 and $347.34 per claim for this code.
90% bill between $17.94 and $520.57.
Top 1% bill above $553.29.
About This Procedure
HCPCS code 81249 was billed by 33 providers across 8,460 claims, totaling $919K in Medicaid payments from 2018–2024. This code was used for 7,528 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$111.06
Providers Billing
16
National Spending
$919K
Avg/Median Ratio
1.85×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 81249
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1326484569 | $363K |
| 2 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $223K |
| 3 | 1457977209 | $133K |
| 4 | 1588066278 | $86K |
| 5 | 1447843750 | $47K |
| 6 | 1558067199 | $14K |
| 7 | 1396384251 | $14K |
| 8 | 1518713072 | $13K |
| 9 | Bioconfirm Laboratories Llc Doraville, GA · Clinical Medical Laboratory | $8K |
| 10 | 1659726487 | $7K |
| 11 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $4K |
| 12 | 1760189898 | $3K |
| 13 | 1891721536 | $2K |
| 14 | 1528653334 | $2K |
| 15 | 1518366426 | $1K |
| 16 | 1861137481 | $12 |
| 17 | 1356657787 | $0 |
| 18 | 1801492558 | $0 |
| 19 | 1396437638 | $0 |
| 20 | 1235600214 | $0 |
Showing top 20 of 33 providers billing this code