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#4762 of 11K

86161

HCPCS Procedure Code

HCPCS code 86161 is the #4,762 most-billed Medicaid procedure code, with $416K in payments across 40K claims from 2018–2024. The national median cost per claim is $7.21.

Total Paid

$416K

0.00% of all spending

Total Claims

40K

Providers

48

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for 86161? Based on 48 providers billing this code nationally.

Median

$7.21

Average

$9.48

Std Dev

$17.72

Max

$125.84

Percentile Distribution (Cost per Claim)

p10
$0.61
p25
$3.34
Median
$7.21
p75
$10.81
p90
$12.13
p95
$14.81
p99
$75.66

50% of providers bill between $3.34 and $10.81 per claim for this code.

90% bill between $0.61 and $12.13.

Top 1% bill above $75.66.

About This Procedure

HCPCS code 86161 was billed by 48 providers across 40K claims, totaling $416K in Medicaid payments from 2018–2024. This code was used for 37K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.21

Providers Billing

48

National Spending

$416K

Avg/Median Ratio

1.31×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86161

#ProviderTotal Paid
1Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$166K
2Driscoll Childrens Hospital

Corpus Christi, TX · Speech-Language Pathologist,

$89K
3Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$47K
41639179328$19K
51447255153$12K
6Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$12K
7Bronxcare Health System

Bronx, NY · General Acute Care Hospital

$10K
8Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$10K
91447233861$9K
101447296272$8K
11Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$5K
12Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$5K
13Bethesda Hospital Inc

Cincinnati, OH · General Acute Care Hospital

$4K
141568405793$4K
151134220031$2K
16Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$2K
171902896905$2K
181730209545$1K
19Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$1K
20Quest Diagnostics Clinical Laboratories Inc

Irving, TX · Clinical Medical Laboratory

$961

Showing top 20 of 48 providers billing this code