86325
HCPCS Procedure Code
HCPCS code 86325 is the #6,396 most-billed Medicaid procedure code, with $69K in payments across 6K claims from 2018–2024. The national median cost per claim is $15.59. Costs vary widely — the 90th percentile is $43.80 per claim, 2.8× the median.
Total Paid
$69K
0.00% of all spending
Total Claims
6K
Providers
12
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for 86325? Based on 10 providers billing this code nationally.
Median
$15.59
Average
$19.59
Std Dev
$13.98
Max
$45.35
Percentile Distribution (Cost per Claim)
50% of providers bill between $9.90 and $21.12 per claim for this code.
90% bill between $7.92 and $43.80.
Top 1% bill above $45.19.
About This Procedure
HCPCS code 86325 was billed by 12 providers across 6K claims, totaling $69K in Medicaid payments from 2018–2024. This code was used for 6K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$15.59
Providers Billing
10
National Spending
$69K
Avg/Median Ratio
1.26×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86325
| # | Provider | Total Paid |
|---|---|---|
| 1 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $23K |
| 2 | 1801874573 | $19K |
| 3 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $13K |
| 4 | 1912966458 | $8K |
| 5 | 1942641774 | $2K |
| 6 | 1669499414 | $1K |
| 7 | 1447255153 | $634 |
| 8 | Nyu Langone Hospitals New York, NY · Clinic/Center, Oncology | $575 |
| 9 | Mid Atlantic Pemanente Medical Group Rockville, MD · Health Maintenance Organization | $567 |
| 10 | 1477596310 | $271 |
| 11 | 1528074507 | $0 |
| 12 | Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital | $0 |
Showing top 12 of 12 providers billing this code