86225
HCPCS Procedure Code
HCPCS code 86225 is the #1,873 most-billed Medicaid procedure code, with $12.4M in payments across 2.0M claims from 2018–2024. The national median cost per claim is $7.93.
Total Paid
$12.4M
0.00% of all spending
Total Claims
2.0M
Providers
802
Avg Cost/Claim
$6
National Cost Distribution
How much do providers bill per claim for 86225? Based on 744 providers billing this code nationally.
Median
$7.93
Average
$8.80
Std Dev
$7.68
Max
$107.09
Percentile Distribution (Cost per Claim)
50% of providers bill between $4.55 and $11.62 per claim for this code.
90% bill between $1.72 and $14.66.
Top 1% bill above $31.13.
About This Procedure
HCPCS code 86225 was billed by 802 providers across 2.0M claims, totaling $12.4M in Medicaid payments from 2018–2024. This code was used for 1.9M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$7.93
Providers Billing
744
National Spending
$12.4M
Avg/Median Ratio
1.11×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86225
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $890K |
| 2 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $590K |
| 3 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $579K |
| 4 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $578K |
| 5 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $424K |
| 6 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $390K |
| 7 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $278K |
| 8 | Laboratory Corporation Of America Phoenix, AZ · Clinical Medical Laboratory | $267K |
| 9 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $246K |
| 10 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $242K |
| 11 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $196K |
| 12 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $184K |
| 13 | Laboratory Corporation Of America San Diego, CA · Clinical Medical Laboratory | $181K |
| 14 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $170K |
| 15 | Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory | $158K |
| 16 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $155K |
| 17 | 1235186800 | $149K |
| 18 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $144K |
| 19 | Permanente Medical Group Inc. Berkeley, CA · Clinical Medical Laboratory | $137K |
| 20 | Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory | $137K |
Showing top 20 of 802 providers billing this code