86794
HCPCS Procedure Code
HCPCS code 86794 is the #5,416 most-billed Medicaid procedure code, with $205K in payments across 21K claims from 2018–2024. The national median cost per claim is $9.70.
Total Paid
$205K
0.00% of all spending
Total Claims
21K
Providers
21
Avg Cost/Claim
$10
National Cost Distribution
How much do providers bill per claim for 86794? Based on 21 providers billing this code nationally.
Median
$9.70
Average
$9.64
Std Dev
$5.10
Max
$21.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $8.00 and $11.52 per claim for this code.
90% bill between $2.77 and $16.66.
Top 1% bill above $20.24.
About This Procedure
HCPCS code 86794 was billed by 21 providers across 21K claims, totaling $205K in Medicaid payments from 2018–2024. This code was used for 21K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$9.70
Providers Billing
21
National Spending
$205K
Avg/Median Ratio
0.99×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86794
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $89K |
| 2 | Laboratory Corporation Of America Houston, TX · Clinical Medical Laboratory | $51K |
| 3 | 1780620526 | $17K |
| 4 | Doctors Hospital At Renaissance, Ltd Edinburg, TX · Clinic/Center, Ambulatory Surgical | $9K |
| 5 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $6K |
| 6 | Unilab Corporation Sacramento, CA · Clinical Medical Laboratory | $6K |
| 7 | 1124130653 | $6K |
| 8 | Laboratory Corporation Of America Holdings Research Triangle Park, NC · Clinical Medical Laboratory | $6K |
| 9 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $5K |
| 10 | Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory | $3K |
| 11 | 1407301401 | $2K |
| 12 | 1225033020 | $1K |
| 13 | 1891731626 | $1K |
| 14 | Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory | $788 |
| 15 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $784 |
| 16 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $649 |
| 17 | 1447296272 | $461 |
| 18 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $378 |
| 19 | Laboratory Corporation Of America Phoenix, AZ · Clinical Medical Laboratory | $184 |
| 20 | 1891873303 | $113 |
Showing top 20 of 21 providers billing this code