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#3837 of 11K

81309

HCPCS Procedure Code

HCPCS code 81309 is the #3,837 most-billed Medicaid procedure code, with $1.1M in payments across 20K claims from 2018–2024. The national median cost per claim is $25.05. Costs vary widely — the 90th percentile is $56.41 per claim, 2.3× the median.

Total Paid

$1.1M

0.00% of all spending

Total Claims

20K

Providers

16

Avg Cost/Claim

$55

National Cost Distribution

How much do providers bill per claim for 81309? Based on 14 providers billing this code nationally.

Median

$25.05

Average

$36.29

Std Dev

$44.68

Max

$175.33

Percentile Distribution (Cost per Claim)

p10
$3.88
p25
$8.01
Median
$25.05
p75
$48.23
p90
$56.41
p95
$99.09
p99
$160.08

50% of providers bill between $8.01 and $48.23 per claim for this code.

90% bill between $3.88 and $56.41.

Top 1% bill above $160.08.

About This Procedure

HCPCS code 81309 was billed by 16 providers across 20K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 18K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$25.05

Providers Billing

14

National Spending

$1.1M

Avg/Median Ratio

1.45×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81309

#ProviderTotal Paid
11013973866$756K
21184045619$113K
31740733708$111K
41457977209$63K
5Invitae Corporation

San Francisco, CA · Clinical Medical Laboratory

$39K
61447843750$18K
71528653334$1K
81275292294$1K
91760189898$808
101013525286$528
111134439573$468
121770207607$220
131871169706$218
141932843836$11
151881334290$0
161851059588$0

Showing top 16 of 16 providers billing this code