86160
HCPCS Procedure Code
HCPCS code 86160 is the #1,636 most-billed Medicaid procedure code, with $17.3M in payments across 1.8M claims from 2018–2024. The national median cost per claim is $11.42. Costs vary widely — the 90th percentile is $25.50 per claim, 2.2× the median.
Total Paid
$17.3M
0.00% of all spending
Total Claims
1.8M
Providers
826
Avg Cost/Claim
$10
National Cost Distribution
How much do providers bill per claim for 86160? Based on 774 providers billing this code nationally.
Median
$11.42
Average
$13.88
Std Dev
$15.18
Max
$170.43
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.23 and $16.79 per claim for this code.
90% bill between $2.55 and $25.50.
Top 1% bill above $73.81.
About This Procedure
HCPCS code 86160 was billed by 826 providers across 1.8M claims, totaling $17.3M in Medicaid payments from 2018–2024. This code was used for 1.5M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$11.42
Providers Billing
774
National Spending
$17.3M
Avg/Median Ratio
1.22×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86160
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $917K |
| 2 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $916K |
| 3 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $565K |
| 4 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $529K |
| 5 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $389K |
| 6 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $360K |
| 7 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $294K |
| 8 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $285K |
| 9 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $263K |
| 10 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $253K |
| 11 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $248K |
| 12 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $247K |
| 13 | Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory | $212K |
| 14 | Laboratory Corporation Of America Seattle, WA · Clinical Medical Laboratory | $205K |
| 15 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $199K |
| 16 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $195K |
| 17 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $193K |
| 18 | 1265418669 | $189K |
| 19 | Quest Diagnostics Llc Marlborough, MA · Clinical Medical Laboratory | $163K |
| 20 | Laboratory Corporation Of America San Diego, CA · Clinical Medical Laboratory | $159K |
Showing top 20 of 826 providers billing this code