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#2469 of 11K

86304

HCPCS Procedure Code

HCPCS code 86304 is the #2,469 most-billed Medicaid procedure code, with $5.6M in payments across 600K claims from 2018–2024. The national median cost per claim is $11.08.

Total Paid

$5.6M

0.00% of all spending

Total Claims

600K

Providers

461

Avg Cost/Claim

$9

National Cost Distribution

How much do providers bill per claim for 86304? Based on 439 providers billing this code nationally.

Median

$11.08

Average

$12.59

Std Dev

$12.28

Max

$188.67

Percentile Distribution (Cost per Claim)

p10
$2.57
p25
$6.55
Median
$11.08
p75
$16.93
p90
$20.25
p95
$23.06
p99
$47.37

50% of providers bill between $6.55 and $16.93 per claim for this code.

90% bill between $2.57 and $20.25.

Top 1% bill above $47.37.

About This Procedure

HCPCS code 86304 was billed by 461 providers across 600K claims, totaling $5.6M in Medicaid payments from 2018–2024. This code was used for 534K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.08

Providers Billing

439

National Spending

$5.6M

Avg/Median Ratio

1.14×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86304

#ProviderTotal Paid
1Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$384K
2Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$236K
3Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$201K
4Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$194K
5Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$158K
6Dana-farber Cancer Institute, Inc.

Boston, MA · General Acute Care Hospital

$155K
7Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$133K
8Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$122K
9Quest Diagnostics Llc Il

Wood Dale, IL · Clinical Medical Laboratory

$96K
10Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$93K
11Permanente Medical Group, Inc.

Richmond, CA · Clinical Medical Laboratory

$90K
12Women & Infants Hospital Of Rhode Island

Providence, RI · Clinic/Center, Ambulatory Family Planning Facility

$88K
13Labone Llc

Lenexa, KS · Clinical Medical Laboratory

$87K
14Lenco Diagnostic Laboratories,inc.

Brooklyn, NY · Clinical Medical Laboratory

$85K
15Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$82K
16Laboratory Corporation Of America

Seattle, WA · Clinical Medical Laboratory

$74K
17University Of Kentucky

Lexington, KY · General Acute Care Hospital

$73K
181164402038$67K
19Laboratory Corporation Of America

Tampa, FL · Clinical Medical Laboratory

$64K
201891873303$61K

Showing top 20 of 461 providers billing this code