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#3211 of 11K

86318

HCPCS Procedure Code

HCPCS code 86318 is the #3,211 most-billed Medicaid procedure code, with $2.2M in payments across 178K claims from 2018–2024. The national median cost per claim is $11.61.

Total Paid

$2.2M

0.00% of all spending

Total Claims

178K

Providers

306

Avg Cost/Claim

$12

National Cost Distribution

How much do providers bill per claim for 86318? Based on 256 providers billing this code nationally.

Median

$11.61

Average

$14.80

Std Dev

$37.80

Max

$554.48

Percentile Distribution (Cost per Claim)

p10
$2.53
p25
$6.63
Median
$11.61
p75
$15.94
p90
$18.25
p95
$24.01
p99
$71.81

50% of providers bill between $6.63 and $15.94 per claim for this code.

90% bill between $2.53 and $18.25.

Top 1% bill above $71.81.

About This Procedure

HCPCS code 86318 was billed by 306 providers across 178K claims, totaling $2.2M in Medicaid payments from 2018–2024. This code was used for 153K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.61

Providers Billing

256

National Spending

$2.2M

Avg/Median Ratio

1.27×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86318

#ProviderTotal Paid
1Spartanburg Medical Center

Spartanburg, SC · Ambulance

$484K
21942221098$454K
31396316212$184K
41245452747$82K
51669058285$76K
6Doctors Hospital At Renaissance, Ltd

Edinburg, TX · Clinic/Center, Ambulatory Surgical

$74K
71548538200$55K
81871548016$41K
91073606901$41K
101134158900$30K
111679805493$29K
121033646781$28K
131477902641$27K
141013924372$23K
151285902106$23K
161295813764$22K
171548208440$21K
18Riverside University Health Systems - Medical Center

Moreno Valley, CA · General Acute Care Hospital

$21K
19Health Network Laboratories, Llc

Allentown, PA · Clinical Medical Laboratory

$17K
201629099163$15K

Showing top 20 of 306 providers billing this code