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#7025 of 11K

81315

HCPCS Procedure Code

HCPCS code 81315 is the #7,025 most-billed Medicaid procedure code, with $31K in payments across 864 claims from 2018–2024. The national median cost per claim is $34.88.

Total Paid

$31K

0.00% of all spending

Total Claims

864

Providers

4

Avg Cost/Claim

$36

National Cost Distribution

How much do providers bill per claim for 81315? Based on 4 providers billing this code nationally.

Median

$34.88

Average

$38.72

Std Dev

$14.30

Max

$58.81

Percentile Distribution (Cost per Claim)

p10
$27.79
p25
$30.01
Median
$34.88
p75
$43.59
p90
$52.72
p95
$55.77
p99
$58.20

50% of providers bill between $30.01 and $43.59 per claim for this code.

90% bill between $27.79 and $52.72.

Top 1% bill above $58.20.

About This Procedure

HCPCS code 81315 was billed by 4 providers across 864 claims, totaling $31K in Medicaid payments from 2018–2024. This code was used for 823 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$34.88

Providers Billing

4

National Spending

$31K

Avg/Median Ratio

1.11×

Normal distribution

Provider Coverage

We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.