81275
HCPCS Procedure Code
HCPCS code 81275 is the #3,457 most-billed Medicaid procedure code, with $1.7M in payments across 41K claims from 2018–2024. The national median cost per claim is $39.82. Costs vary widely — the 90th percentile is $126.26 per claim, 3.2× the median.
Total Paid
$1.7M
0.00% of all spending
Total Claims
41K
Providers
24
Avg Cost/Claim
$40
National Cost Distribution
How much do providers bill per claim for 81275? Based on 18 providers billing this code nationally.
Median
$39.82
Average
$55.65
Std Dev
$41.83
Max
$154.60
Percentile Distribution (Cost per Claim)
50% of providers bill between $34.63 and $62.94 per claim for this code.
90% bill between $18.46 and $126.26.
Top 1% bill above $152.72.
About This Procedure
HCPCS code 81275 was billed by 24 providers across 41K claims, totaling $1.7M in Medicaid payments from 2018–2024. This code was used for 38K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$39.82
Providers Billing
18
National Spending
$1.7M
Avg/Median Ratio
1.40×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 81275
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1013973866 | $738K |
| 2 | Natera Inc. San Carlos, CA · Clinical Medical Laboratory | $300K |
| 3 | 1184045619 | $201K |
| 4 | 1740733708 | $174K |
| 5 | 1447437355 | $79K |
| 6 | 1265714091 | $32K |
| 7 | 1457977209 | $24K |
| 8 | 1508215922 | $23K |
| 9 | 1447843750 | $22K |
| 10 | 1134438427 | $18K |
| 11 | 1205834769 | $17K |
| 12 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $13K |
| 13 | 1538559919 | $6K |
| 14 | 1396384251 | $3K |
| 15 | 1740460583 | $2K |
| 16 | 1871615708 | $990 |
| 17 | 1699115857 | $842 |
| 18 | 1528653334 | $758 |
| 19 | Lsu Health Sciences Center Shreveport Faculty Group Practice Shreveport, LA · Oral & Maxillofacial Surgery | $0 |
| 20 | 1881334290 | $0 |
Showing top 20 of 24 providers billing this code