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#5074 of 11K

86835

HCPCS Procedure Code

HCPCS code 86835 is the #5,074 most-billed Medicaid procedure code, with $301K in payments across 8K claims from 2018–2024. The national median cost per claim is $94.32. Costs vary widely — the 90th percentile is $435.92 per claim, 4.6× the median.

Total Paid

$301K

0.00% of all spending

Total Claims

8K

Providers

11

Avg Cost/Claim

$36

National Cost Distribution

How much do providers bill per claim for 86835? Based on 11 providers billing this code nationally.

Median

$94.32

Average

$166.06

Std Dev

$182.11

Max

$546.87

Percentile Distribution (Cost per Claim)

p10
$18.25
p25
$25.87
Median
$94.32
p75
$242.28
p90
$435.92
p95
$491.40
p99
$535.78

50% of providers bill between $25.87 and $242.28 per claim for this code.

90% bill between $18.25 and $435.92.

Top 1% bill above $535.78.

About This Procedure

HCPCS code 86835 was billed by 11 providers across 8K claims, totaling $301K in Medicaid payments from 2018–2024. This code was used for 7K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$94.32

Providers Billing

11

National Spending

$301K

Avg/Median Ratio

1.76×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 86835

#ProviderTotal Paid
11932280666$127K
2Seattle Children's Hospital

Seattle, WA · Prosthetic/Orthotic Supplier

$56K
3University Of Washington

Seattle, WA · Clinic/Center, Dental

$28K
4Children's Hospital Corporation

Boston, MA · Clinic/Center

$27K
5Children's Hospital

Washington, DC · General Acute Care Hospital Children

$19K
61285667493$10K
7Adventist Health System-sunbelt, Inc

Orlando, FL · Ambulance, Land Transport

$10K
8Texas Children's Hospital

Houston, TX · General Acute Care Hospital Children

$8K
9Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$7K
101427145176$7K
111215930987$2K

Showing top 11 of 11 providers billing this code