86021
HCPCS Procedure Code
HCPCS code 86021 is the #3,603 most-billed Medicaid procedure code, with $1.4M in payments across 193K claims from 2018–2024. The national median cost per claim is $7.05.
Total Paid
$1.4M
0.00% of all spending
Total Claims
193K
Providers
109
Avg Cost/Claim
$7
National Cost Distribution
How much do providers bill per claim for 86021? Based on 102 providers billing this code nationally.
Median
$7.05
Average
$8.60
Std Dev
$7.56
Max
$48.02
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.99 and $10.91 per claim for this code.
90% bill between $2.56 and $13.95.
Top 1% bill above $41.41.
About This Procedure
HCPCS code 86021 was billed by 109 providers across 193K claims, totaling $1.4M in Medicaid payments from 2018–2024. This code was used for 174K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$7.05
Providers Billing
102
National Spending
$1.4M
Avg/Median Ratio
1.22×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86021
| # | Provider | Total Paid |
|---|---|---|
| 1 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $196K |
| 2 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $192K |
| 3 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $113K |
| 4 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $85K |
| 5 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $80K |
| 6 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $59K |
| 7 | Quest Diagnostics Llc Marlborough, MA · Clinical Medical Laboratory | $48K |
| 8 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $47K |
| 9 | 1891731626 | $43K |
| 10 | 1447296272 | $41K |
| 11 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $38K |
| 12 | Quest Diagnostics Massachusetts Llc Marlborough, MA · Clinical Medical Laboratory | $37K |
| 13 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $31K |
| 14 | 1770529513 | $31K |
| 15 | Nyu Langone Hospitals New York, NY · Clinic/Center, Oncology | $30K |
| 16 | Quest Diagnostics Of Pennsylvania, Inc. Pittsburgh, PA · Clinical Medical Laboratory | $25K |
| 17 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $22K |
| 18 | 1316983158 | $22K |
| 19 | Sunrise Medical Laboratories, Inc. Hicksville, NY · Clinical Medical Laboratory | $20K |
| 20 | 1215930987 | $18K |
Showing top 20 of 109 providers billing this code