86328
HCPCS Procedure Code
HCPCS code 86328 is the #1,465 most-billed Medicaid procedure code, with $22.3M in payments across 842K claims from 2018–2024. The national median cost per claim is $20.52. Costs vary widely — the 90th percentile is $42.07 per claim, 2.1× the median.
Total Paid
$22.3M
0.00% of all spending
Total Claims
842K
Providers
1K
Avg Cost/Claim
$26
National Cost Distribution
How much do providers bill per claim for 86328? Based on 1K providers billing this code nationally.
Median
$20.52
Average
$24.81
Std Dev
$16.38
Max
$303.78
Percentile Distribution (Cost per Claim)
50% of providers bill between $17.90 and $33.75 per claim for this code.
90% bill between $8.87 and $42.07.
Top 1% bill above $70.82.
About This Procedure
HCPCS code 86328 was billed by 1K providers across 842K claims, totaling $22.3M in Medicaid payments from 2018–2024. This code was used for 720K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$20.52
Providers Billing
1K
National Spending
$22.3M
Avg/Median Ratio
1.21×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86328
| # | Provider | Total Paid |
|---|---|---|
| 1 | Rainbow Lab Inc Chicago, IL · Clinical Medical Laboratory | $1.3M |
| 2 | 1821005950 | $1.2M |
| 3 | Sh Diagnostics Inc Chicago, IL · Clinical Medical Laboratory | $756K |
| 4 | Mnr Industries Llc Bel Air, MD · Clinic/Center Urgent Care | $610K |
| 5 | 1689009854 | $536K |
| 6 | 1821288606 | $479K |
| 7 | 1164402038 | $420K |
| 8 | 1417061011 | $378K |
| 9 | 1124545934 | $345K |
| 10 | 1790083012 | $344K |
| 11 | 1851357560 | $285K |
| 12 | 1992372312 | $252K |
| 13 | 1649323601 | $223K |
| 14 | 1336361575 | $198K |
| 15 | 1891251849 | $195K |
| 16 | 1215402870 | $185K |
| 17 | 1790010064 | $182K |
| 18 | 1558339366 | $174K |
| 19 | 1518996040 | $171K |
| 20 | 1225591829 | $169K |
Showing top 20 of 1K providers billing this code