81294
HCPCS Procedure Code
HCPCS code 81294 is the #3,917 most-billed Medicaid procedure code, with $1.0M in payments across 26K claims from 2018–2024. The national median cost per claim is $18.95. Costs vary widely — the 90th percentile is $75.92 per claim, 4.0× the median.
Total Paid
$1.0M
0.00% of all spending
Total Claims
26K
Providers
19
Avg Cost/Claim
$40
National Cost Distribution
How much do providers bill per claim for 81294? Based on 17 providers billing this code nationally.
Median
$18.95
Average
$32.08
Std Dev
$34.83
Max
$130.53
Percentile Distribution (Cost per Claim)
50% of providers bill between $7.67 and $46.07 per claim for this code.
90% bill between $1.62 and $75.92.
Top 1% bill above $122.45.
About This Procedure
HCPCS code 81294 was billed by 19 providers across 26K claims, totaling $1.0M in Medicaid payments from 2018–2024. This code was used for 23K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$18.95
Providers Billing
17
National Spending
$1.0M
Avg/Median Ratio
1.69×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 81294
| # | Provider | Total Paid |
|---|---|---|
| 1 | Myriad Genetic Laboratories, Inc. Salt Lake City, UT · Clinical Medical Laboratory | $494K |
| 2 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $188K |
| 3 | Speciality Screening Llc Wauwatosa, WI · Clinical Medical Laboratory | $121K |
| 4 | 1861568784 | $100K |
| 5 | Bioconfirm Laboratories Llc Doraville, GA · Clinical Medical Laboratory | $34K |
| 6 | Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics | $27K |
| 7 | 1639577091 | $24K |
| 8 | 1790023547 | $10K |
| 9 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $9K |
| 10 | 1649225632 | $4K |
| 11 | 1518415991 | $2K |
| 12 | 1699172866 | $972 |
| 13 | 1740733708 | $602 |
| 14 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $345 |
| 15 | 1811484447 | $320 |
| 16 | 1417407727 | $314 |
| 17 | 1518713072 | $218 |
| 18 | 1336598325 | $0 |
| 19 | 1174009245 | $0 |
Showing top 19 of 19 providers billing this code