86828
HCPCS Procedure Code
HCPCS code 86828 is the #3,738 most-billed Medicaid procedure code, with $1.2M in payments across 34K claims from 2018–2024. The national median cost per claim is $18.67. Costs vary widely — the 90th percentile is $60.89 per claim, 3.3× the median.
Total Paid
$1.2M
0.00% of all spending
Total Claims
34K
Providers
46
Avg Cost/Claim
$37
National Cost Distribution
How much do providers bill per claim for 86828? Based on 46 providers billing this code nationally.
Median
$18.67
Average
$28.21
Std Dev
$26.23
Max
$105.07
Percentile Distribution (Cost per Claim)
50% of providers bill between $7.75 and $44.45 per claim for this code.
90% bill between $5.58 and $60.89.
Top 1% bill above $99.49.
About This Procedure
HCPCS code 86828 was billed by 46 providers across 34K claims, totaling $1.2M in Medicaid payments from 2018–2024. This code was used for 27K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$18.67
Providers Billing
46
National Spending
$1.2M
Avg/Median Ratio
1.51×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 86828
| # | Provider | Total Paid |
|---|---|---|
| 1 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $422K |
| 2 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $238K |
| 3 | Sharp Memorial Hospital San Diego, CA · General Acute Care Hospital, Women | $114K |
| 4 | Banner - University Medical Center Tucson Campus Llc Tucson, AZ · Clinic/Center, Multi-Specialty | $62K |
| 5 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $55K |
| 6 | 1689744450 | $49K |
| 7 | 1992703540 | $48K |
| 8 | 1437119310 | $37K |
| 9 | Keck Medical Center Of Usc Los Angeles, CA · General Acute Care Hospital | $34K |
| 10 | Newark Beth Israel Medical Center Inc Newark, NJ · General Acute Care Hospital | $31K |
| 11 | William Beaumont Hospital Royal Oak, MI · General Acute Care Hospital | $21K |
| 12 | The Milton S Hershey Medical Center Hershey, PA · General Acute Care Hospital | $17K |
| 13 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $17K |
| 14 | 1225033020 | $14K |
| 15 | Adventist Health System-sunbelt, Inc Orlando, FL · Ambulance, Land Transport | $13K |
| 16 | Children's Hospital Washington, DC · General Acute Care Hospital Children | $10K |
| 17 | Inova Health Care Services Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder | $8K |
| 18 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $6K |
| 19 | 1568431088 | $6K |
| 20 | Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital | $5K |
Showing top 20 of 46 providers billing this code