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#1616 of 11K

81422

HCPCS Procedure Code

HCPCS code 81422 is the #1,616 most-billed Medicaid procedure code, with $17.7M in payments across 251K claims from 2018–2024. The national median cost per claim is $60.25. Costs vary widely — the 90th percentile is $200.00 per claim, 3.3× the median.

Total Paid

$17.7M

0.00% of all spending

Total Claims

251K

Providers

45

Avg Cost/Claim

$71

National Cost Distribution

How much do providers bill per claim for 81422? Based on 31 providers billing this code nationally.

Median

$60.25

Average

$114.08

Std Dev

$169.66

Max

$657.26

Percentile Distribution (Cost per Claim)

p10
$2.00
p25
$15.48
Median
$60.25
p75
$119.09
p90
$200.00
p95
$563.80
p99
$639.23

50% of providers bill between $15.48 and $119.09 per claim for this code.

90% bill between $2.00 and $200.00.

Top 1% bill above $639.23.

About This Procedure

HCPCS code 81422 was billed by 45 providers across 251K claims, totaling $17.7M in Medicaid payments from 2018–2024. This code was used for 219K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$60.25

Providers Billing

31

National Spending

$17.7M

Avg/Median Ratio

1.89×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 81422

#ProviderTotal Paid
1Natera Inc.

San Carlos, CA · Clinical Medical Laboratory

$10.5M
21235528225$1.6M
3Myriad Women's Health, Inc.

South San Francisco, CA · Clinical Medical Laboratory

$1.4M
4Laboratory Corporation Of America Holdings

Research Triangle Park, NC · Clinical Medical Laboratory

$897K
5St Josephs University Medical Center Inc.

Paterson, NJ · General Acute Care Hospital

$691K
61598314437$635K
71730481078$395K
81518415991$326K
9Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$307K
10Sherman Abrams Laboratory Inc

Brooklyn, NY · Clinical Medical Laboratory

$241K
111366720906$217K
121013924372$154K
13New York City Health And Hospitals Corporation

Bronx, NY · Internal Medicine

$88K
14Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$69K
15Invitae Corporation

San Francisco, CA · Clinical Medical Laboratory

$64K
161114222817$36K
171235234402$26K
18Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$18K
19Laboratory Corporation Of America

San Diego, CA · Clinical Medical Laboratory

$15K
20Laboratory Corporation Of America Holdings

Birmingham, AL · Clinical Medical Laboratory

$14K

Showing top 20 of 45 providers billing this code