#2046 of 11K

81317

HCPCS Procedure Code

HCPCS code 81317 is the #2,046 most-billed Medicaid procedure code, with $9.7M in payments across 59K claims from 2018–2024. The national median cost per claim is $103.43. Costs vary widely — the 90th percentile is $559.24 per claim, 5.4× the median.

Total Paid

$9.7M

0.00% of all spending

Total Claims

59K

Providers

Avg Cost/Claim

$165

National Cost Distribution

How much do providers bill per claim for 81317? Based on 57 providers billing this code nationally.

Median

$103.43

Average

$209.48

Std Dev

$250.48

Max

$1,061.90

Percentile Distribution (Cost per Claim)

p10

$4.93

p25

$35.52

Median

$103.43

p75

$283.73

p90

$559.24

p95

$669.05

p99

$1,000.19

50% of providers bill between $35.52 and $283.73 per claim for this code.

90% bill between $4.93 and $559.24.

Top 1% bill above $1,000.19.

About This Procedure

HCPCS code 81317 was billed by 78 providers across 59K claims, totaling $9.7M in Medicaid payments from 2018–2024. This code was used for 52K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$103.43

Providers Billing

National Spending

$9.7M

Avg/Median Ratio

2.03×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 81317

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Invitae Corporation San Francisco, CA · Clinical Medical Laboratory	$2.0M	$103.43	1.0× median	Below Median
2	Myriad Genetic Laboratories, Inc. Salt Lake City, UT · Clinical Medical Laboratory	$1.9M	$283.73	2.7× median	Above 75th
3	1861568784	$1.2M	$174.78	1.7× median	Above Median
4	1790023547	$650K	$260.50	2.5× median	Above Median
5	1689971822	$624K	$459.61	4.4× median	Above 75th
6	1740733708	$622K	$95.31	0.9× median	Below Median
7	Bioconfirm Laboratories Llc Doraville, GA · Clinical Medical Laboratory	$621K	$274.07	2.6× median	Above Median
8	1003221904	$358K	$637.23	6.2× median	Top 10%
9	1659726487	$247K	$951.71	9.2× median	Top 10%
10	Crestar Labs Llc Spring Hill, TN · Clinical Medical Laboratory	$192K	$261.06	2.5× median	Above Median
11	1902347891	$190K	$616.78	6.0× median	Top 10%
12	1639577091	$168K	$155.85	1.5× median	Above Median
13	1457977209	$160K	$444.72	4.3× median	Above 75th
14	1316311863	$146K	$255.02	2.5× median	Above Median
15	1649225632	$71K	$314.76	3.0× median	Above 75th
16	1619232204	$59K	$128.93	1.2× median	Above Median
17	1730628439	$57K	$1,061.90	10.3× median	Top 1%
18	1447843750	$52K	$71.10	0.7× median	Below Median
19	Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory	$49K	$66.42	0.6× median	Below Median
20	1346641875	$44K	$122.70	1.2× median	Above Median

Showing top 20 of 78 providers billing this code

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81321$8.2M 81307$6.9M 81311$2.1M 81319$1.4M 81314$1.3M

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