81256
HCPCS Procedure Code
HCPCS code 81256 is the #4,067 most-billed Medicaid procedure code, with $875K in payments across 45K claims from 2018–2024. The national median cost per claim is $18.15. Costs vary widely — the 90th percentile is $44.08 per claim, 2.4× the median.
Total Paid
$875K
0.00% of all spending
Total Claims
45K
Providers
63
Avg Cost/Claim
$20
National Cost Distribution
How much do providers bill per claim for 81256? Based on 57 providers billing this code nationally.
Median
$18.15
Average
$23.23
Std Dev
$25.77
Max
$145.90
Percentile Distribution (Cost per Claim)
50% of providers bill between $7.92 and $30.03 per claim for this code.
90% bill between $2.44 and $44.08.
Top 1% bill above $129.12.
About This Procedure
HCPCS code 81256 was billed by 63 providers across 45K claims, totaling $875K in Medicaid payments from 2018–2024. This code was used for 42K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$18.15
Providers Billing
57
National Spending
$875K
Avg/Median Ratio
1.28×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 81256
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $219K |
| 2 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $120K |
| 3 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $77K |
| 4 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $54K |
| 5 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $40K |
| 6 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $34K |
| 7 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $34K |
| 8 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $31K |
| 9 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $26K |
| 10 | Laboratory Corporation Of America San Diego, CA · Clinical Medical Laboratory | $21K |
| 11 | 1124438528 | $20K |
| 12 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $18K |
| 13 | 1780620526 | $17K |
| 14 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $16K |
| 15 | 1457977209 | $15K |
| 16 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $13K |
| 17 | 1720409154 | $11K |
| 18 | 1316983158 | $9K |
| 19 | Laboratory Corporation Of America Seattle, WA · Clinical Medical Laboratory | $9K |
| 20 | 1447296272 | $8K |
Showing top 20 of 63 providers billing this code