#2173 of 11K

81321

HCPCS Procedure Code

HCPCS code 81321 is the #2,173 most-billed Medicaid procedure code, with $8.2M in payments across 68K claims from 2018–2024. The national median cost per claim is $81.34. Costs vary widely — the 90th percentile is $517.39 per claim, 6.4× the median.

Total Paid

$8.2M

0.00% of all spending

Total Claims

68K

Providers

Avg Cost/Claim

$122

National Cost Distribution

How much do providers bill per claim for 81321? Based on 71 providers billing this code nationally.

Median

$81.34

Average

$173.39

Std Dev

$222.93

Max

$914.36

Percentile Distribution (Cost per Claim)

p10

$5.62

p25

$28.16

Median

$81.34

p75

$218.91

p90

$517.39

p95

$656.11

p99

$882.38

50% of providers bill between $28.16 and $218.91 per claim for this code.

90% bill between $5.62 and $517.39.

Top 1% bill above $882.38.

About This Procedure

HCPCS code 81321 was billed by 90 providers across 68K claims, totaling $8.2M in Medicaid payments from 2018–2024. This code was used for 60K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$81.34

Providers Billing

National Spending

$8.2M

Avg/Median Ratio

2.13×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 81321

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1013973866	$1.8M	$110.70	1.4× median	Above Median
2	1790023547	$772K	$281.28	3.5× median	Above 75th
3	Invitae Corporation San Francisco, CA · Clinical Medical Laboratory	$712K	$61.92	0.8× median	Below Median
4	Bioconfirm Laboratories Llc Doraville, GA · Clinical Medical Laboratory	$589K	$258.05	3.2× median	Above 75th
5	Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics	$585K	$81.82	1.0× median	Above Median
6	1184045619	$575K	$118.16	1.5× median	Above Median
7	1689971822	$543K	$517.39	6.4× median	Above 75th
8	1861568784	$423K	$174.78	2.1× median	Above Median
9	1003221904	$362K	$606.59	7.5× median	Top 10%
10	1740733708	$339K	$91.03	1.1× median	Above Median
11	1659726487	$227K	$868.67	10.7× median	Top 10%
12	1639577091	$130K	$156.53	1.9× median	Above Median
13	Crestar Labs Llc Spring Hill, TN · Clinical Medical Laboratory	$124K	$351.88	4.3× median	Above 75th
14	Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory	$123K	$94.70	1.2× median	Above Median
15	1265714091	$86K	$124.27	1.5× median	Above Median
16	1649225632	$84K	$253.79	3.1× median	Above 75th
17	1447843750	$77K	$41.53	0.5× median	Below Median
18	1518415991	$74K	$114.88	1.4× median	Above Median
19	1730628439	$66K	$761.68	9.4× median	Top 10%
20	1508215922	$63K	$109.77	1.3× median	Above Median

Showing top 20 of 90 providers billing this code

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