#2066 of 11K

81298

HCPCS Procedure Code

HCPCS code 81298 is the #2,066 most-billed Medicaid procedure code, with $9.5M in payments across 70K claims from 2018–2024. The national median cost per claim is $74.37. Costs vary widely — the 90th percentile is $607.26 per claim, 8.2× the median.

Total Paid

$9.5M

0.00% of all spending

Total Claims

70K

Providers

Avg Cost/Claim

$135

National Cost Distribution

How much do providers bill per claim for 81298? Based on 55 providers billing this code nationally.

Median

$74.37

Average

$216.04

Std Dev

$311.15

Max

$1,401.59

Percentile Distribution (Cost per Claim)

p10

$4.80

p25

$23.92

Median

$74.37

p75

$287.23

p90

$607.26

p95

$822.60

p99

$1,304.55

50% of providers bill between $23.92 and $287.23 per claim for this code.

90% bill between $4.80 and $607.26.

Top 1% bill above $1,304.55.

About This Procedure

HCPCS code 81298 was billed by 73 providers across 70K claims, totaling $9.5M in Medicaid payments from 2018–2024. This code was used for 63K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$74.37

Providers Billing

National Spending

$9.5M

Avg/Median Ratio

2.90×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 81298

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Myriad Genetic Laboratories, Inc. Salt Lake City, UT · Clinical Medical Laboratory	$1.5M	$213.68	2.9× median	Above Median
2	Invitae Corporation San Francisco, CA · Clinical Medical Laboratory	$1.3M	$71.19	1.0× median	Below Median
3	1013973866	$1.2M	$92.34	1.2× median	Above Median
4	1861568784	$1.1M	$155.82	2.1× median	Above Median
5	1790023547	$721K	$283.00	3.8× median	Above Median
6	1689971822	$671K	$641.24	8.6× median	Top 10%
7	Bioconfirm Laboratories Llc Doraville, GA · Clinical Medical Laboratory	$664K	$293.05	3.9× median	Above 75th
8	1740733708	$431K	$65.50	0.9× median	Below Median
9	1003221904	$408K	$679.13	9.1× median	Top 10%
10	1659726487	$274K	$1,057.14	14.2× median	Top 10%
11	1639577091	$263K	$291.46	3.9× median	Above 75th
12	1457977209	$151K	$419.60	5.6× median	Above 75th
13	1730628439	$139K	$1,401.59	18.8× median	Top 1%
14	Crestar Labs Llc Spring Hill, TN · Clinical Medical Laboratory	$96K	$274.03	3.7× median	Above Median
15	1902347891	$78K	$1,221.88	16.4× median	Top 10%
16	Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory	$70K	$75.76	1.0× median	Above Median
17	1447843750	$47K	$64.51	0.9× median	Below Median
18	1346641875	$41K	$119.31	1.6× median	Above Median
19	1346486644	$37K	$273.36	3.7× median	Above Median
20	1649225632	$36K	$145.02	1.9× median	Above Median

Showing top 20 of 73 providers billing this code

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