86759
HCPCS Procedure Code
HCPCS code 86759 is the #5,846 most-billed Medicaid procedure code, with $129K in payments across 12K claims from 2018–2024. The national median cost per claim is $12.98.
Total Paid
$129K
0.00% of all spending
Total Claims
12K
Providers
7
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for 86759? Based on 6 providers billing this code nationally.
Median
$12.98
Average
$12.35
Std Dev
$5.77
Max
$18.29
Percentile Distribution (Cost per Claim)
50% of providers bill between $11.04 and $16.19 per claim for this code.
90% bill between $6.31 and $17.76.
Top 1% bill above $18.24.
About This Procedure
HCPCS code 86759 was billed by 7 providers across 12K claims, totaling $129K in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$12.98
Providers Billing
6
National Spending
$129K
Avg/Median Ratio
0.95×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86759
| # | Provider | Total Paid |
|---|---|---|
| 1 | Physicians Group Laboratories, Llc Houma, LA · Clinical Medical Laboratory | $84K |
| 2 | 1114081056 | $22K |
| 3 | 1467066860 | $16K |
| 4 | 1316970932 | $6K |
| 5 | 1437222312 | $1K |
| 6 | 1316924913 | $448 |
| 7 | 1427136357 | $0 |
Showing top 7 of 7 providers billing this code