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#3886 of 11K

81402

HCPCS Procedure Code

HCPCS code 81402 is the #3,886 most-billed Medicaid procedure code, with $1.1M in payments across 50K claims from 2018–2024. The national median cost per claim is $26.09. Costs vary widely — the 90th percentile is $66.69 per claim, 2.6× the median.

Total Paid

$1.1M

0.00% of all spending

Total Claims

50K

Providers

40

Avg Cost/Claim

$21

National Cost Distribution

How much do providers bill per claim for 81402? Based on 39 providers billing this code nationally.

Median

$26.09

Average

$36.81

Std Dev

$41.74

Max

$215.34

Percentile Distribution (Cost per Claim)

p10
$4.29
p25
$12.37
Median
$26.09
p75
$45.83
p90
$66.69
p95
$103.46
p99
$189.28

50% of providers bill between $12.37 and $45.83 per claim for this code.

90% bill between $4.29 and $66.69.

Top 1% bill above $189.28.

About This Procedure

HCPCS code 81402 was billed by 40 providers across 50K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 45K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$26.09

Providers Billing

39

National Spending

$1.1M

Avg/Median Ratio

1.41×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81402

#ProviderTotal Paid
11467850859$369K
2Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$98K
31184045619$91K
41518415991$82K
5Laboratory Corporation Of America Holdings

Research Triangle Park, NC · Clinical Medical Laboratory

$63K
6Natera Inc.

San Carlos, CA · Clinical Medical Laboratory

$59K
71447437355$36K
81750373908$29K
91326484569$25K
10Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$24K
111114222817$22K
12Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$20K
131699115857$18K
141689975021$17K
15Mid Atlantic Pemanente Medical Group

Rockville, MD · Health Maintenance Organization

$16K
161235234402$12K
17Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$11K
18Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$7K
191003221904$7K
20Myriad Women's Health, Inc.

South San Francisco, CA · Clinical Medical Laboratory

$6K

Showing top 20 of 40 providers billing this code