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#6429 of 11K

86305

HCPCS Procedure Code

HCPCS code 86305 is the #6,429 most-billed Medicaid procedure code, with $66K in payments across 6K claims from 2018–2024. The national median cost per claim is $11.59.

Total Paid

$66K

0.00% of all spending

Total Claims

6K

Providers

9

Avg Cost/Claim

$12

National Cost Distribution

How much do providers bill per claim for 86305? Based on 9 providers billing this code nationally.

Median

$11.59

Average

$10.43

Std Dev

$7.38

Max

$19.13

Percentile Distribution (Cost per Claim)

p10
$1.73
p25
$2.62
Median
$11.59
p75
$18.33
p90
$18.50
p95
$18.81
p99
$19.06

50% of providers bill between $2.62 and $18.33 per claim for this code.

90% bill between $1.73 and $18.50.

Top 1% bill above $19.06.

About This Procedure

HCPCS code 86305 was billed by 9 providers across 6K claims, totaling $66K in Medicaid payments from 2018–2024. This code was used for 5K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.59

Providers Billing

9

National Spending

$66K

Avg/Median Ratio

0.90×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86305

#ProviderTotal Paid
1University Of Rochester

Rochester, NY · General Acute Care Hospital

$27K
2Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$18K
3Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$14K
4Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$5K
5Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$1K
61861409823$477
7Rochester General Hospital-lab

Rochester, NY · Clinical Medical Laboratory

$293
8Laboratory Corporation Of America

San Diego, CA · Clinical Medical Laboratory

$198
91205477957$79

Showing top 9 of 9 providers billing this code