81403
HCPCS Procedure Code
HCPCS code 81403 is the #2,452 most-billed Medicaid procedure code, with $5.7M in payments across 143K claims from 2018–2024. The national median cost per claim is $42.54. Costs vary widely — the 90th percentile is $141.84 per claim, 3.3× the median.
Total Paid
$5.7M
0.00% of all spending
Total Claims
143K
Providers
123
Avg Cost/Claim
$40
National Cost Distribution
How much do providers bill per claim for 81403? Based on 90 providers billing this code nationally.
Median
$42.54
Average
$59.92
Std Dev
$59.91
Max
$293.55
Percentile Distribution (Cost per Claim)
50% of providers bill between $18.80 and $71.15 per claim for this code.
90% bill between $5.64 and $141.84.
Top 1% bill above $245.15.
About This Procedure
HCPCS code 81403 was billed by 123 providers across 143K claims, totaling $5.7M in Medicaid payments from 2018–2024. This code was used for 122K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$42.54
Providers Billing
90
National Spending
$5.7M
Avg/Median Ratio
1.41×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 81403
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1013973866 | $1.0M |
| 2 | 1598314437 | $869K |
| 3 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $695K |
| 4 | Natera Inc. San Carlos, CA · Clinical Medical Laboratory | $431K |
| 5 | 1689971822 | $359K |
| 6 | Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics | $348K |
| 7 | 1861568784 | $238K |
| 8 | 1184045619 | $189K |
| 9 | 1790023547 | $161K |
| 10 | Bioconfirm Laboratories Llc Doraville, GA · Clinical Medical Laboratory | $155K |
| 11 | 1003221904 | $102K |
| 12 | Speciality Screening Llc Wauwatosa, WI · Clinical Medical Laboratory | $81K |
| 13 | Crestar Labs Llc Spring Hill, TN · Clinical Medical Laboratory | $74K |
| 14 | 1659726487 | $73K |
| 15 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $72K |
| 16 | 1447437355 | $69K |
| 17 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $67K |
| 18 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $50K |
| 19 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $46K |
| 20 | 1902347891 | $42K |
Showing top 20 of 123 providers billing this code