86005
HCPCS Procedure Code
HCPCS code 86005 is the #5,374 most-billed Medicaid procedure code, with $217K in payments across 69K claims from 2018–2024. The national median cost per claim is $5.03.
Total Paid
$217K
0.00% of all spending
Total Claims
69K
Providers
33
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for 86005? Based on 24 providers billing this code nationally.
Median
$5.03
Average
$5.46
Std Dev
$4.71
Max
$20.98
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.20 and $7.58 per claim for this code.
90% bill between $0.51 and $10.03.
Top 1% bill above $18.72.
About This Procedure
HCPCS code 86005 was billed by 33 providers across 69K claims, totaling $217K in Medicaid payments from 2018–2024. This code was used for 65K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$5.03
Providers Billing
24
National Spending
$217K
Avg/Median Ratio
1.09×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86005
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $130K |
| 2 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $28K |
| 3 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $18K |
| 4 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $15K |
| 5 | Laboratory Corporation Of America Phoenix, AZ · Clinical Medical Laboratory | $11K |
| 6 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $3K |
| 7 | Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory | $2K |
| 8 | 1104829159 | $2K |
| 9 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $2K |
| 10 | The Lowell General Hospital Lowell, MA · Pharmacy, Institutional Pharmacy | $1K |
| 11 | William Beaumont Hospital Royal Oak, MI · General Acute Care Hospital | $1K |
| 12 | 1306825997 | $639 |
| 13 | 1114070224 | $588 |
| 14 | Laboratory Corporation Of America San Diego, CA · Clinical Medical Laboratory | $449 |
| 15 | Oakwood Healthcare, Inc. Dearborn, MI · General Acute Care Hospital | $394 |
| 16 | 1073587937 | $334 |
| 17 | 1285688697 | $245 |
| 18 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $142 |
| 19 | 1508027624 | $101 |
| 20 | 1205056371 | $91 |
Showing top 20 of 33 providers billing this code