86830
HCPCS Procedure Code
HCPCS code 86830 is the #4,966 most-billed Medicaid procedure code, with $336K in payments across 7K claims from 2018–2024. The national median cost per claim is $30.55. Costs vary widely — the 90th percentile is $64.91 per claim, 2.1× the median.
Total Paid
$336K
0.00% of all spending
Total Claims
7K
Providers
13
Avg Cost/Claim
$45
National Cost Distribution
How much do providers bill per claim for 86830? Based on 13 providers billing this code nationally.
Median
$30.55
Average
$36.15
Std Dev
$24.09
Max
$80.48
Percentile Distribution (Cost per Claim)
50% of providers bill between $16.37 and $51.82 per claim for this code.
90% bill between $11.26 and $64.91.
Top 1% bill above $78.97.
About This Procedure
HCPCS code 86830 was billed by 13 providers across 7K claims, totaling $336K in Medicaid payments from 2018–2024. This code was used for 6K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$30.55
Providers Billing
13
National Spending
$336K
Avg/Median Ratio
1.18×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86830
| # | Provider | Total Paid |
|---|---|---|
| 1 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $177K |
| 2 | 1164493847 | $35K |
| 3 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $32K |
| 4 | Sharp Memorial Hospital San Diego, CA · General Acute Care Hospital, Women | $29K |
| 5 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $25K |
| 6 | Inova Health Care Services Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder | $11K |
| 7 | 1700120938 | $11K |
| 8 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $10K |
| 9 | 1639172372 | $4K |
| 10 | 1154392231 | $1K |
| 11 | 1437197985 | $391 |
| 12 | 1568431088 | $354 |
| 13 | North Carolina Baptist Hospital Winston Salem, NC · General Acute Care Hospital | $295 |
Showing top 13 of 13 providers billing this code