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#7155 of 11K

86596

HCPCS Procedure Code

HCPCS code 86596 is the #7,155 most-billed Medicaid procedure code, with $27K in payments across 2K claims from 2018–2024. The national median cost per claim is $11.28. Costs vary widely — the 90th percentile is $30.85 per claim, 2.7× the median.

Total Paid

$27K

0.00% of all spending

Total Claims

2K

Providers

10

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for 86596? Based on 9 providers billing this code nationally.

Median

$11.28

Average

$14.77

Std Dev

$11.84

Max

$36.78

Percentile Distribution (Cost per Claim)

p10
$4.03
p25
$5.63
Median
$11.28
p75
$20.55
p90
$30.85
p95
$33.82
p99
$36.18

50% of providers bill between $5.63 and $20.55 per claim for this code.

90% bill between $4.03 and $30.85.

Top 1% bill above $36.18.

About This Procedure

HCPCS code 86596 was billed by 10 providers across 2K claims, totaling $27K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.28

Providers Billing

9

National Spending

$27K

Avg/Median Ratio

1.31×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86596

#ProviderTotal Paid
1Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$10K
21780620526$6K
3Labone Of Ohio Inc

Cincinnati, OH · Clinical Medical Laboratory

$4K
4Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$4K
5Mayo Collaborative Services, Inc

Rochester, MN · Clinical Medical Laboratory

$1K
6Quest Diagnostics Incorporated

Las Vegas, NV · Clinical Medical Laboratory

$467
7Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$382
8The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$228
9Clinical Pathology Laboratories, Inc.

Austin, TX · Clinical Medical Laboratory

$186
10Laboratory Corporation Of America

San Diego, CA · Clinical Medical Laboratory

$0

Showing top 10 of 10 providers billing this code