81254
HCPCS Procedure Code
HCPCS code 81254 is the #6,367 most-billed Medicaid procedure code, with $71K in payments across 9,042 claims from 2018–2024. The national median cost per claim is $4.71. Costs vary widely — the 90th percentile is $19.82 per claim, 4.2× the median.
Total Paid
$71K
0.00% of all spending
Total Claims
9,042
Providers
12
Avg Cost/Claim
$8
National Cost Distribution
How much do providers bill per claim for 81254? Based on 8 providers billing this code nationally.
Median
$4.71
Average
$8.40
Std Dev
$8.88
Max
$22.30
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.41 and $15.49 per claim for this code.
90% bill between $0.45 and $19.82.
Top 1% bill above $22.06.
About This Procedure
HCPCS code 81254 was billed by 12 providers across 9,042 claims, totaling $71K in Medicaid payments from 2018–2024. This code was used for 7,964 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$4.71
Providers Billing
8
National Spending
$71K
Avg/Median Ratio
1.78×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 81254
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1790023547 | $48K |
| 2 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $10K |
| 3 | 1457977209 | $6K |
| 4 | Natera Inc. San Carlos, CA · Clinical Medical Laboratory | $5K |
| 5 | 1326484569 | $1K |
| 6 | Myriad Women's Health, Inc. South San Francisco, CA · Clinical Medical Laboratory | $691 |
| 7 | 1568860062 | $24 |
| 8 | 1770207607 | $1 |
| 9 | 1609449941 | $0 |
| 10 | 1215055256 | $0 |
| 11 | 1275292294 | $0 |
| 12 | 1043271539 | $0 |
Showing top 12 of 12 providers billing this code