86850
HCPCS Procedure Code
HCPCS code 86850 is the #613 most-billed Medicaid procedure code, with $125.8M in payments across 13.5M claims from 2018–2024. The national median cost per claim is $5.44. Costs vary widely — the 90th percentile is $24.67 per claim, 4.5× the median.
Total Paid
$125.8M
0.01% of all spending
Total Claims
13.5M
Providers
4K
Avg Cost/Claim
$9
National Cost Distribution
How much do providers bill per claim for 86850? Based on 3K providers billing this code nationally.
Median
$5.44
Average
$11.09
Std Dev
$25.59
Max
$688.45
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.82 and $11.14 per claim for this code.
90% bill between $0.48 and $24.67.
Top 1% bill above $97.24.
About This Procedure
HCPCS code 86850 was billed by 4K providers across 13.5M claims, totaling $125.8M in Medicaid payments from 2018–2024. This code was used for 11.8M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$5.44
Providers Billing
3K
National Spending
$125.8M
Avg/Median Ratio
2.04×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 86850
| # | Provider | Total Paid |
|---|---|---|
| 1 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $5.2M |
| 2 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $3.8M |
| 3 | Dallas County Hospital District Dallas, TX · Clinic/Center, Ambulatory Surgical | $2.7M |
| 4 | 1114081056 | $2.0M |
| 5 | 1649726738 | $1.8M |
| 6 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $1.7M |
| 7 | Women & Infants Hospital Of Rhode Island Providence, RI · Clinic/Center, Ambulatory Family Planning Facility | $1.5M |
| 8 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $1.5M |
| 9 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $1.2M |
| 10 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $928K |
| 11 | University Of Texas Medical Branch At Galveston Galveston, TX · Clinic/Center, Ambulatory Surgical | $908K |
| 12 | 1154373843 | $884K |
| 13 | 1326046467 | $877K |
| 14 | 1700886322 | $853K |
| 15 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $797K |
| 16 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $784K |
| 17 | Doctors Hospital At Renaissance, Ltd Edinburg, TX · Clinic/Center, Ambulatory Surgical | $762K |
| 18 | Port City Operating Company Llc Stockton, CA · General Acute Care Hospital | $760K |
| 19 | 1487868097 | $757K |
| 20 | 1649299827 | $732K |
Showing top 20 of 4K providers billing this code