Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1142 of 11K

86360

HCPCS Procedure Code

HCPCS code 86360 is the #1,142 most-billed Medicaid procedure code, with $37.7M in payments across 1.6M claims from 2018–2024. The national median cost per claim is $26.97.

Total Paid

$37.7M

0.00% of all spending

Total Claims

1.6M

Providers

552

Avg Cost/Claim

$24

National Cost Distribution

How much do providers bill per claim for 86360? Based on 522 providers billing this code nationally.

Median

$26.97

Average

$28.23

Std Dev

$21.23

Max

$189.34

Percentile Distribution (Cost per Claim)

p10
$3.89
p25
$12.69
Median
$26.97
p75
$40.27
p90
$50.27
p95
$61.02
p99
$101.49

50% of providers bill between $12.69 and $40.27 per claim for this code.

90% bill between $3.89 and $50.27.

Top 1% bill above $101.49.

About This Procedure

HCPCS code 86360 was billed by 552 providers across 1.6M claims, totaling $37.7M in Medicaid payments from 2018–2024. This code was used for 1.5M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$26.97

Providers Billing

522

National Spending

$37.7M

Avg/Median Ratio

1.05×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86360

#ProviderTotal Paid
1Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$3.2M
2Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$3.1M
3Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$2.5M
4Laboratory Corporation Of America

Tampa, FL · Clinical Medical Laboratory

$1.4M
5Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$1.2M
6Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$1.1M
7Laboratory Corporation Of America Holdings

Birmingham, AL · Clinical Medical Laboratory

$880K
8Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$841K
9Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$567K
10Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$508K
11New York City Health And Hospitals Corporation

Bronx, NY · Internal Medicine

$454K
12Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$448K
13Quest Diagnostics Llc Il

Wood Dale, IL · Clinical Medical Laboratory

$427K
14Laboratory Corporation Of America

San Diego, CA · Clinical Medical Laboratory

$402K
15University Of Kentucky

Lexington, KY · General Acute Care Hospital

$376K
16Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$364K
17Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$353K
181447233861$347K
19Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$343K
201447477252$342K

Showing top 20 of 552 providers billing this code