81415
HCPCS Procedure Code
HCPCS code 81415 is the #843 most-billed Medicaid procedure code, with $68.5M in payments across 72K claims from 2018–2024. The national median cost per claim is $1,342.29. Costs vary widely — the 90th percentile is $3,128.48 per claim, 2.3× the median.
Total Paid
$68.5M
0.01% of all spending
Total Claims
72K
Providers
20
Avg Cost/Claim
$954
National Cost Distribution
How much do providers bill per claim for 81415? Based on 19 providers billing this code nationally.
Median
$1,342.29
Average
$1,729.03
Std Dev
$1,192.23
Max
$4,421.05
Percentile Distribution (Cost per Claim)
50% of providers bill between $866.53 and $2,291.17 per claim for this code.
90% bill between $355.48 and $3,128.48.
Top 1% bill above $4,372.77.
About This Procedure
HCPCS code 81415 was billed by 20 providers across 72K claims, totaling $68.5M in Medicaid payments from 2018–2024. This code was used for 65K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$1,342.29
Providers Billing
19
National Spending
$68.5M
Avg/Median Ratio
1.29×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 81415
| # | Provider | Total Paid |
|---|---|---|
| 1 | Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics | $59.4M |
| 2 | 1629512140 | $1.9M |
| 3 | 1861568784 | $1.7M |
| 4 | 1699095901 | $1.7M |
| 5 | 1629109137 | $940K |
| 6 | 1306875877 | $928K |
| 7 | 1043414113 | $415K |
| 8 | 1386148971 | $357K |
| 9 | Seattle Children's Hospital Seattle, WA · Prosthetic/Orthotic Supplier | $268K |
| 10 | The Children's Mercy Hospital Kansas City, MO · General Acute Care Hospital Children | $225K |
| 11 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $201K |
| 12 | Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children | $195K |
| 13 | Invitae Corporation San Francisco, CA · Clinical Medical Laboratory | $72K |
| 14 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $72K |
| 15 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $63K |
| 16 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $41K |
| 17 | Vanderbilt University Medical Center Nashville, TN · Psychiatric Unit | $38K |
| 18 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $21K |
| 19 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $15K |
| 20 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $0 |
Showing top 20 of 20 providers billing this code