81297
HCPCS Procedure Code
HCPCS code 81297 is the #4,170 most-billed Medicaid procedure code, with $785K in payments across 23K claims from 2018–2024. The national median cost per claim is $16.81. Costs vary widely — the 90th percentile is $56.54 per claim, 3.4× the median.
Total Paid
$785K
0.00% of all spending
Total Claims
23K
Providers
17
Avg Cost/Claim
$34
National Cost Distribution
How much do providers bill per claim for 81297? Based on 15 providers billing this code nationally.
Median
$16.81
Average
$24.11
Std Dev
$22.49
Max
$69.74
Percentile Distribution (Cost per Claim)
50% of providers bill between $7.99 and $36.74 per claim for this code.
90% bill between $0.83 and $56.54.
Top 1% bill above $69.03.
About This Procedure
HCPCS code 81297 was billed by 17 providers across 23K claims, totaling $785K in Medicaid payments from 2018–2024. This code was used for 21K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$16.81
Providers Billing
15
National Spending
$785K
Avg/Median Ratio
1.43×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 81297
| # | Provider | Total Paid |
|---|---|---|
| 1 | Myriad Genetic Laboratories, Inc. Salt Lake City, UT · Clinical Medical Laboratory | $435K |
| 2 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $150K |
| 3 | 1861568784 | $95K |
| 4 | Bioconfirm Laboratories Llc Doraville, GA · Clinical Medical Laboratory | $60K |
| 5 | 1639577091 | $21K |
| 6 | 1790023547 | $11K |
| 7 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $6K |
| 8 | 1649225632 | $3K |
| 9 | 1518415991 | $2K |
| 10 | 1699172866 | $1K |
| 11 | 1740733708 | $595 |
| 12 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $345 |
| 13 | 1417407727 | $250 |
| 14 | 1518713072 | $160 |
| 15 | 1811484447 | $121 |
| 16 | 1336598325 | $0 |
| 17 | 1174009245 | $0 |
Showing top 17 of 17 providers billing this code