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#7308 of 11K

81261

HCPCS Procedure Code

HCPCS code 81261 is the #7,308 most-billed Medicaid procedure code, with $22K in payments across 595 claims from 2018–2024. The national median cost per claim is $35.59.

Total Paid

$22K

0.00% of all spending

Total Claims

595

Providers

2

Avg Cost/Claim

$36

National Cost Distribution

How much do providers bill per claim for 81261? Based on 2 providers billing this code nationally.

Median

$35.59

Average

$35.59

Std Dev

$23.77

Max

$52.40

Percentile Distribution (Cost per Claim)

p10
$22.15
p25
$27.19
Median
$35.59
p75
$43.99
p90
$49.03
p95
$50.72
p99
$52.06

50% of providers bill between $27.19 and $43.99 per claim for this code.

90% bill between $22.15 and $49.03.

Top 1% bill above $52.06.

About This Procedure

HCPCS code 81261 was billed by 2 providers across 595 claims, totaling $22K in Medicaid payments from 2018–2024. This code was used for 552 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$35.59

Providers Billing

2

National Spending

$22K

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.