86849
HCPCS Procedure Code
HCPCS code 86849 is the #5,533 most-billed Medicaid procedure code, with $180K in payments across 17K claims from 2018–2024. The national median cost per claim is $8.39. Costs vary widely — the 90th percentile is $35.26 per claim, 4.2× the median.
Total Paid
$180K
0.00% of all spending
Total Claims
17K
Providers
30
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for 86849? Based on 26 providers billing this code nationally.
Median
$8.39
Average
$14.40
Std Dev
$20.90
Max
$97.13
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.03 and $14.16 per claim for this code.
90% bill between $0.79 and $35.26.
Top 1% bill above $84.84.
About This Procedure
HCPCS code 86849 was billed by 30 providers across 17K claims, totaling $180K in Medicaid payments from 2018–2024. This code was used for 15K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$8.39
Providers Billing
26
National Spending
$180K
Avg/Median Ratio
1.72×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 86849
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1285798918 | $55K |
| 2 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $27K |
| 3 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $18K |
| 4 | 1144266024 | $14K |
| 5 | 1619972254 | $11K |
| 6 | A2cl Services, Llc West Allis, WI · Clinical Medical Laboratory | $10K |
| 7 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $10K |
| 8 | Temple University Hospital Inc Philadelphia, PA · General Acute Care Hospital | $9K |
| 9 | 1417359142 | $7K |
| 10 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $7K |
| 11 | 1356307581 | $4K |
| 12 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $3K |
| 13 | Bexar County Hospital District San Antonio, TX · Clinical Medical Laboratory | $2K |
| 14 | 1063466282 | $1K |
| 15 | Keck Medical Center Of Usc Los Angeles, CA · General Acute Care Hospital | $890 |
| 16 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $390 |
| 17 | 1215914585 | $333 |
| 18 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $269 |
| 19 | University Of Colorado Hospital Authority Aurora, CO · General Acute Care Hospital | $248 |
| 20 | 1932280666 | $172 |
Showing top 20 of 30 providers billing this code