86226
HCPCS Procedure Code
HCPCS code 86226 is the #6,312 most-billed Medicaid procedure code, with $76K in payments across 8K claims from 2018–2024. The national median cost per claim is $8.99.
Total Paid
$76K
0.00% of all spending
Total Claims
8K
Providers
26
Avg Cost/Claim
$10
National Cost Distribution
How much do providers bill per claim for 86226? Based on 22 providers billing this code nationally.
Median
$8.99
Average
$8.20
Std Dev
$4.35
Max
$17.35
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.31 and $11.34 per claim for this code.
90% bill between $1.20 and $12.63.
Top 1% bill above $16.40.
About This Procedure
HCPCS code 86226 was billed by 26 providers across 8K claims, totaling $76K in Medicaid payments from 2018–2024. This code was used for 7K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$8.99
Providers Billing
22
National Spending
$76K
Avg/Median Ratio
0.91×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86226
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1972625499 | $34K |
| 2 | 1073702635 | $15K |
| 3 | 1801989454 | $9K |
| 4 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $6K |
| 5 | 1902848633 | $3K |
| 6 | 1821286766 | $2K |
| 7 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $2K |
| 8 | 1225048838 | $1K |
| 9 | 1275596439 | $1K |
| 10 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $925 |
| 11 | 1750381281 | $555 |
| 12 | 1447366919 | $321 |
| 13 | 1528248242 | $320 |
| 14 | 1538570528 | $191 |
| 15 | 1457522567 | $130 |
| 16 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $122 |
| 17 | 1073587937 | $117 |
| 18 | 1780634279 | $85 |
| 19 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $72 |
| 20 | 1548530702 | $36 |
Showing top 20 of 26 providers billing this code