81286
HCPCS Procedure Code
HCPCS code 81286 is the #6,130 most-billed Medicaid procedure code, with $92K in payments across 2K claims from 2018–2024. The national median cost per claim is $31.04. Costs vary widely — the 90th percentile is $152.53 per claim, 4.9× the median.
Total Paid
$92K
0.00% of all spending
Total Claims
2K
Providers
21
Avg Cost/Claim
$42
National Cost Distribution
How much do providers bill per claim for 81286? Based on 10 providers billing this code nationally.
Median
$31.04
Average
$66.55
Std Dev
$72.94
Max
$209.45
Percentile Distribution (Cost per Claim)
50% of providers bill between $12.91 and $122.15 per claim for this code.
90% bill between $7.30 and $152.53.
Top 1% bill above $203.75.
About This Procedure
HCPCS code 81286 was billed by 21 providers across 2K claims, totaling $92K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$31.04
Providers Billing
10
National Spending
$92K
Avg/Median Ratio
2.14×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 81286
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1609388842 | $70K |
| 2 | 1275292294 | $8K |
| 3 | 1518039486 | $6K |
| 4 | 1316311863 | $5K |
| 5 | 1366820870 | $2K |
| 6 | Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics | $1K |
| 7 | 1770207607 | $276 |
| 8 | 1013525286 | $258 |
| 9 | 1134439573 | $248 |
| 10 | 1932843836 | $11 |
| 11 | 1427595354 | $0 |
| 12 | 1316558828 | $0 |
| 13 | 1962921445 | $0 |
| 14 | 1942813050 | $0 |
| 15 | 1033602560 | $0 |
| 16 | 1245835594 | $0 |
| 17 | 1467967745 | $0 |
| 18 | 1265846695 | $0 |
| 19 | 1386023620 | $0 |
| 20 | 1821684515 | $0 |
Showing top 20 of 21 providers billing this code