81251
HCPCS Procedure Code
HCPCS code 81251 is the #2,352 most-billed Medicaid procedure code, with $6.5M in payments across 481K claims from 2018–2024. The national median cost per claim is $17.93. Costs vary widely — the 90th percentile is $45.96 per claim, 2.6× the median.
Total Paid
$6.5M
0.00% of all spending
Total Claims
481K
Providers
66
Avg Cost/Claim
$14
National Cost Distribution
How much do providers bill per claim for 81251? Based on 59 providers billing this code nationally.
Median
$17.93
Average
$30.91
Std Dev
$50.06
Max
$316.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $7.17 and $36.21 per claim for this code.
90% bill between $2.26 and $45.96.
Top 1% bill above $244.80.
About This Procedure
HCPCS code 81251 was billed by 66 providers across 481K claims, totaling $6.5M in Medicaid payments from 2018–2024. This code was used for 419K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$17.93
Providers Billing
59
National Spending
$6.5M
Avg/Median Ratio
1.72×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 81251
| # | Provider | Total Paid |
|---|---|---|
| 1 | Natera Inc. San Carlos, CA · Clinical Medical Laboratory | $2.7M |
| 2 | 1114222817 | $949K |
| 3 | 1790023547 | $591K |
| 4 | 1689975021 | $407K |
| 5 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $329K |
| 6 | Myriad Women's Health, Inc. South San Francisco, CA · Clinical Medical Laboratory | $273K |
| 7 | 1235528225 | $216K |
| 8 | 1518415991 | $175K |
| 9 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $136K |
| 10 | 1326484569 | $123K |
| 11 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $66K |
| 12 | 1104829159 | $59K |
| 13 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $50K |
| 14 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $48K |
| 15 | New York City Health And Hospitals Corporation Elmhurst, NY · Internal Medicine | $43K |
| 16 | 1063892396 | $42K |
| 17 | New York City Health And Hospitals Corporation Brooklyn, NY · Internal Medicine | $25K |
| 18 | Sherman Abrams Laboratory Inc Brooklyn, NY · Clinical Medical Laboratory | $24K |
| 19 | New York City Health And Hospitals Corporation New York, NY · Internal Medicine | $22K |
| 20 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $22K |
Showing top 20 of 66 providers billing this code