86603
HCPCS Procedure Code
HCPCS code 86603 is the #7,965 most-billed Medicaid procedure code, with $8K in payments across 3K claims from 2018–2024. The national median cost per claim is $10.61. Costs vary widely — the 90th percentile is $33.98 per claim, 3.2× the median.
Total Paid
$8K
0.00% of all spending
Total Claims
3K
Providers
5
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for 86603? Based on 5 providers billing this code nationally.
Median
$10.61
Average
$15.36
Std Dev
$17.78
Max
$44.89
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.23 and $17.62 per claim for this code.
90% bill between $1.78 and $33.98.
Top 1% bill above $43.80.
About This Procedure
HCPCS code 86603 was billed by 5 providers across 3K claims, totaling $8K in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$10.61
Providers Billing
5
National Spending
$8K
Avg/Median Ratio
1.45×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86603
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1750381281 | $6K |
| 2 | County Of Ventura Ventura, CA · Clinic/Center, Emergency Care | $634 |
| 3 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $616 |
| 4 | 1073567608 | $584 |
| 5 | 1609818954 | $458 |
Showing top 5 of 5 providers billing this code