81425
HCPCS Procedure Code
HCPCS code 81425 is the #2,934 most-billed Medicaid procedure code, with $3.0M in payments across 3K claims from 2018–2024. The national median cost per claim is $576.97. Costs vary widely — the 90th percentile is $1,390.23 per claim, 2.4× the median.
Total Paid
$3.0M
0.00% of all spending
Total Claims
3K
Providers
6
Avg Cost/Claim
$1K
National Cost Distribution
How much do providers bill per claim for 81425? Based on 5 providers billing this code nationally.
Median
$576.97
Average
$768.80
Std Dev
$572.13
Max
$1,676.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $316.97 and $961.57 per claim for this code.
90% bill between $314.28 and $1,390.23.
Top 1% bill above $1,647.42.
About This Procedure
HCPCS code 81425 was billed by 6 providers across 3K claims, totaling $3.0M in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$576.97
Providers Billing
5
National Spending
$3.0M
Avg/Median Ratio
1.33×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 81425
| # | Provider | Total Paid |
|---|---|---|
| 1 | Genedx Llc Gaithersburg, MD · Medical Genetics, Ph.D. Medical Genetics | $1.5M |
| 2 | 1629512140 | $1.4M |
| 3 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $91K |
| 4 | Seattle Children's Hospital Seattle, WA · Prosthetic/Orthotic Supplier | $18K |
| 5 | 1568860062 | $10K |
| 6 | Alaska Native Tribal Health Consortium Anchorage, AK · General Acute Care Hospital | $0 |
Showing top 6 of 6 providers billing this code