86231
HCPCS Procedure Code
HCPCS code 86231 is the #3,365 most-billed Medicaid procedure code, with $1.8M in payments across 308K claims from 2018–2024. The national median cost per claim is $8.04. Costs vary widely — the 90th percentile is $17.46 per claim, 2.2× the median.
Total Paid
$1.8M
0.00% of all spending
Total Claims
308K
Providers
127
Avg Cost/Claim
$6
National Cost Distribution
How much do providers bill per claim for 86231? Based on 123 providers billing this code nationally.
Median
$8.04
Average
$9.52
Std Dev
$6.56
Max
$33.20
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.81 and $10.50 per claim for this code.
90% bill between $3.42 and $17.46.
Top 1% bill above $31.02.
About This Procedure
HCPCS code 86231 was billed by 127 providers across 308K claims, totaling $1.8M in Medicaid payments from 2018–2024. This code was used for 290K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$8.04
Providers Billing
123
National Spending
$1.8M
Avg/Median Ratio
1.18×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86231
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $415K |
| 2 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $285K |
| 3 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $149K |
| 4 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $120K |
| 5 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $85K |
| 6 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $77K |
| 7 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $71K |
| 8 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $66K |
| 9 | 1649767948 | $44K |
| 10 | 1316983158 | $32K |
| 11 | 1447296272 | $31K |
| 12 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $30K |
| 13 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $29K |
| 14 | 1487212551 | $26K |
| 15 | Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory | $25K |
| 16 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $23K |
| 17 | Sunrise Medical Laboratories, Inc. Hicksville, NY · Clinical Medical Laboratory | $22K |
| 18 | 1902059538 | $18K |
| 19 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $17K |
| 20 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $14K |
Showing top 20 of 127 providers billing this code