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#6721 of 11K

81304

HCPCS Procedure Code

HCPCS code 81304 is the #6,721 most-billed Medicaid procedure code, with $46K in payments across 6,972 claims from 2018–2024. The national median cost per claim is $12.97. Costs vary widely — the 90th percentile is $32.10 per claim, 2.5× the median.

Total Paid

$46K

0.00% of all spending

Total Claims

6,972

Providers

6

Avg Cost/Claim

$7

National Cost Distribution

How much do providers bill per claim for 81304? Based on 4 providers billing this code nationally.

Median

$12.97

Average

$15.96

Std Dev

$16.61

Max

$35.69

Percentile Distribution (Cost per Claim)

p10
$2.21
p25
$2.21
Median
$12.97
p75
$26.71
p90
$32.10
p95
$33.89
p99
$35.33

50% of providers bill between $2.21 and $26.71 per claim for this code.

90% bill between $2.21 and $32.10.

Top 1% bill above $35.33.

About This Procedure

HCPCS code 81304 was billed by 6 providers across 6,972 claims, totaling $46K in Medicaid payments from 2018–2024. This code was used for 6,445 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.97

Providers Billing

4

National Spending

$46K

Avg/Median Ratio

1.23×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81304

#ProviderTotal Paid
1Genedx Llc

Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics

$20K
21861568784$13K
3Invitae Corporation

San Francisco, CA · Clinical Medical Laboratory

$12K
4Laboratory Corporation Of America Holdings

Research Triangle Park, NC · Clinical Medical Laboratory

$222
51518713072$0
61629109137$0

Showing top 6 of 6 providers billing this code