86765
HCPCS Procedure Code
HCPCS code 86765 is the #1,694 most-billed Medicaid procedure code, with $16.0M in payments across 2.2M claims from 2018–2024. The national median cost per claim is $8.72.
Total Paid
$16.0M
0.00% of all spending
Total Claims
2.2M
Providers
604
Avg Cost/Claim
$7
National Cost Distribution
How much do providers bill per claim for 86765? Based on 539 providers billing this code nationally.
Median
$8.72
Average
$9.25
Std Dev
$8.53
Max
$123.88
Percentile Distribution (Cost per Claim)
50% of providers bill between $4.61 and $11.45 per claim for this code.
90% bill between $2.12 and $13.86.
Top 1% bill above $35.26.
About This Procedure
HCPCS code 86765 was billed by 604 providers across 2.2M claims, totaling $16.0M in Medicaid payments from 2018–2024. This code was used for 2.2M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$8.72
Providers Billing
539
National Spending
$16.0M
Avg/Median Ratio
1.06×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86765
| # | Provider | Total Paid |
|---|---|---|
| 1 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $2.5M |
| 2 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $1.9M |
| 3 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $1.4M |
| 4 | Empire City Laboratories, Inc Brooklyn, NY · Clinical Medical Laboratory | $701K |
| 5 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $501K |
| 6 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $443K |
| 7 | Lenco Diagnostic Laboratories,inc. Brooklyn, NY · Clinical Medical Laboratory | $435K |
| 8 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $435K |
| 9 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $355K |
| 10 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $335K |
| 11 | Sunrise Medical Laboratories, Inc. Hicksville, NY · Clinical Medical Laboratory | $310K |
| 12 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $306K |
| 13 | 1467586792 | $227K |
| 14 | Sherman Abrams Laboratory Inc Brooklyn, NY · Clinical Medical Laboratory | $218K |
| 15 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $209K |
| 16 | Quest Diagnostics Massachusetts Llc Marlborough, MA · Clinical Medical Laboratory | $166K |
| 17 | Quest Diagnostics Llc Marlborough, MA · Clinical Medical Laboratory | $159K |
| 18 | Quest Diagnostics Of Pennsylvania, Inc. Pittsburgh, PA · Clinical Medical Laboratory | $157K |
| 19 | Laboratory Corporation Of America Seattle, WA · Clinical Medical Laboratory | $153K |
| 20 | Nyu Langone Hospitals New York, NY · Clinic/Center, Oncology | $129K |
Showing top 20 of 604 providers billing this code