#5647 of 11K

86689

HCPCS Procedure Code

HCPCS code 86689 is the #5,647 most-billed Medicaid procedure code, with $162K in payments across 22K claims from 2018–2024. The national median cost per claim is $11.89. Costs vary widely — the 90th percentile is $28.36 per claim, 2.4× the median.

Total Paid

$162K

0.00% of all spending

Total Claims

22K

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 86689? Based on 37 providers billing this code nationally.

Median

$11.89

Average

$16.42

Std Dev

$24.89

Max

$148.20

Percentile Distribution (Cost per Claim)

p10

$0.33

p25

$1.61

Median

$11.89

p75

$21.51

p90

$28.36

p95

$34.77

p99

$109.52

50% of providers bill between $1.61 and $21.51 per claim for this code.

90% bill between $0.33 and $28.36.

Top 1% bill above $109.52.

About This Procedure

HCPCS code 86689 was billed by 46 providers across 22K claims, totaling $162K in Medicaid payments from 2018–2024. This code was used for 19K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.89

Providers Billing

National Spending

$162K

Avg/Median Ratio

1.38×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86689

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1366695595	$81K	$13.44	1.1× median	Above Median
2	1104896190	$10K	$11.89	1.0× median	Above Median
3	Central Florida Kidney Centers Inc Orlando, FL · Clinic/Center End-Stage Renal Disease (ESRD) Treatment	$9K	$148.20	12.5× median	Top 1%
4	1427602036	$9K	$26.61	2.2× median	Above 75th
5	Tricore Reference Laboratories Albuquerque, NM · Clinical Medical Laboratory	$9K	$25.73	2.2× median	Above 75th
6	1992801021	$8K	$20.20	1.7× median	Above Median
7	1629015698	$7K	$30.97	2.6× median	Top 10%
8	Tricore Inc. Albuquerque, NM · Clinical Medical Laboratory	$4K	$19.07	1.6× median	Above Median
9	1720480668	$3K	$40.74	3.4× median	Top 10%
10	New York City Health And Hospitals Corporation Brooklyn, NY · Internal Medicine	$3K	$6.13	0.5× median	Below Median
11	1497260202	$2K	$21.30	1.8× median	Above Median
12	1548373293	$2K	$7.50	0.6× median	Below Median
13	1023287679	$2K	$0.63	0.1× median	Below Median
14	Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory	$2K	$12.62	1.1× median	Above Median
15	1861906687	$1K	$19.64	1.7× median	Above Median
16	1235500513	$1K	$0.28	0.0× median	Below Median
17	1952869612	$1K	$4.44	0.4× median	Below Median
18	Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory	$1K	$8.62	0.7× median	Below Median
19	1851352256	$930	$0.95	0.1× median	Below Median
20	1578593588	$715	$0.78	0.1× median	Below Median

Showing top 20 of 46 providers billing this code

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