86612
HCPCS Procedure Code
HCPCS code 86612 is the #7,204 most-billed Medicaid procedure code, with $25K in payments across 3K claims from 2018–2024. The national median cost per claim is $7.13. Costs vary widely — the 90th percentile is $15.35 per claim, 2.2× the median.
Total Paid
$25K
0.00% of all spending
Total Claims
3K
Providers
11
Avg Cost/Claim
$9
National Cost Distribution
How much do providers bill per claim for 86612? Based on 11 providers billing this code nationally.
Median
$7.13
Average
$8.95
Std Dev
$3.85
Max
$15.66
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.32 and $10.52 per claim for this code.
90% bill between $6.14 and $15.35.
Top 1% bill above $15.63.
About This Procedure
HCPCS code 86612 was billed by 11 providers across 3K claims, totaling $25K in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$7.13
Providers Billing
11
National Spending
$25K
Avg/Median Ratio
1.26×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86612
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $10K |
| 2 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $8K |
| 3 | 1477596310 | $4K |
| 4 | Quest Diagnostics Incorporated Las Vegas, NV · Clinical Medical Laboratory | $1K |
| 5 | 1467669259 | $532 |
| 6 | 1871130351 | $196 |
| 7 | 1376548271 | $188 |
| 8 | 1891873303 | $168 |
| 9 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $159 |
| 10 | Mayo Collaborative Services, Inc Rochester, MN · Clinical Medical Laboratory | $155 |
| 11 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $135 |
Showing top 11 of 11 providers billing this code