86355
HCPCS Procedure Code
HCPCS code 86355 is the #2,369 most-billed Medicaid procedure code, with $6.3M in payments across 351K claims from 2018–2024. The national median cost per claim is $19.26.
Total Paid
$6.3M
0.00% of all spending
Total Claims
351K
Providers
203
Avg Cost/Claim
$18
National Cost Distribution
How much do providers bill per claim for 86355? Based on 196 providers billing this code nationally.
Median
$19.26
Average
$20.70
Std Dev
$13.49
Max
$89.45
Percentile Distribution (Cost per Claim)
50% of providers bill between $10.94 and $28.66 per claim for this code.
90% bill between $4.44 and $35.00.
Top 1% bill above $62.12.
About This Procedure
HCPCS code 86355 was billed by 203 providers across 351K claims, totaling $6.3M in Medicaid payments from 2018–2024. This code was used for 326K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$19.26
Providers Billing
196
National Spending
$6.3M
Avg/Median Ratio
1.07×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86355
| # | Provider | Total Paid |
|---|---|---|
| 1 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $1.5M |
| 2 | 1225033020 | $309K |
| 3 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $286K |
| 4 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $258K |
| 5 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $206K |
| 6 | University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital | $188K |
| 7 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $166K |
| 8 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $137K |
| 9 | Children's Hospital Corporation Boston, MA · Clinic/Center | $116K |
| 10 | 1568488450 | $115K |
| 11 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $114K |
| 12 | Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children | $101K |
| 13 | Permanente Medical Group, Inc. Richmond, CA · Clinical Medical Laboratory | $96K |
| 14 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $90K |
| 15 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $84K |
| 16 | Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory | $84K |
| 17 | The Brookdale Hospital Medical Center Brooklyn, NY · General Acute Care Hospital | $74K |
| 18 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $74K |
| 19 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $74K |
| 20 | Newark Beth Israel Medical Center Inc Newark, NJ · General Acute Care Hospital | $73K |
Showing top 20 of 203 providers billing this code