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#4169 of 11K

81323

HCPCS Procedure Code

HCPCS code 81323 is the #4,169 most-billed Medicaid procedure code, with $788K in payments across 20K claims from 2018–2024. The national median cost per claim is $28.56. Costs vary widely — the 90th percentile is $111.70 per claim, 3.9× the median.

Total Paid

$788K

0.00% of all spending

Total Claims

20K

Providers

21

Avg Cost/Claim

$39

National Cost Distribution

How much do providers bill per claim for 81323? Based on 18 providers billing this code nationally.

Median

$28.56

Average

$39.43

Std Dev

$48.58

Max

$156.79

Percentile Distribution (Cost per Claim)

p10
$1.66
p25
$4.99
Median
$28.56
p75
$37.21
p90
$111.70
p95
$151.68
p99
$155.77

50% of providers bill between $4.99 and $37.21 per claim for this code.

90% bill between $1.66 and $111.70.

Top 1% bill above $155.77.

About This Procedure

HCPCS code 81323 was billed by 21 providers across 20K claims, totaling $788K in Medicaid payments from 2018–2024. This code was used for 18K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$28.56

Providers Billing

18

National Spending

$788K

Avg/Median Ratio

1.38×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81323

#ProviderTotal Paid
1Speciality Screening Llc

Wauwatosa, WI · Clinical Medical Laboratory

$281K
2Genedx Llc

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

$166K
3Bioconfirm Laboratories Llc

Doraville, GA · Clinical Medical Laboratory

$121K
41639577091$76K
5Invitae Corporation

San Francisco, CA · Clinical Medical Laboratory

$58K
61790023547$41K
71861568784$17K
81649225632$10K
91548835911$6K
10Laboratory Corporation Of America Holdings

Research Triangle Park, NC · Clinical Medical Laboratory

$6K
11Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$3K
121518415991$2K
131699172866$1K
141518713072$462
15Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$345
16Myriad Genetic Laboratories, Inc.

Salt Lake City, UT · Clinical Medical Laboratory

$160
171811484447$144
181417407727$67
191174009245$0
20Lsu Health Sciences Center Shreveport Faculty Group Practice

Shreveport, LA · Oral & Maxillofacial Surgery

$0

Showing top 20 of 21 providers billing this code