86860
HCPCS Procedure Code
HCPCS code 86860 is the #7,438 most-billed Medicaid procedure code, with $18K in payments across 4K claims from 2018–2024. The national median cost per claim is $3.32. Costs vary widely — the 90th percentile is $35.55 per claim, 10.7× the median.
Total Paid
$18K
0.00% of all spending
Total Claims
4K
Providers
9
Avg Cost/Claim
$5
National Cost Distribution
How much do providers bill per claim for 86860? Based on 8 providers billing this code nationally.
Median
$3.32
Average
$15.35
Std Dev
$32.88
Max
$96.39
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.41 and $7.11 per claim for this code.
90% bill between $0.70 and $35.55.
Top 1% bill above $90.31.
About This Procedure
HCPCS code 86860 was billed by 9 providers across 4K claims, totaling $18K in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$3.32
Providers Billing
8
National Spending
$18K
Avg/Median Ratio
4.62×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 86860
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1457354656 | $5K |
| 2 | 1700474608 | $5K |
| 3 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $4K |
| 4 | 1184618829 | $3K |
| 5 | 1922008150 | $246 |
| 6 | Florida Clinical Practice Association Inc Gainesville, FL · Surgery | $111 |
| 7 | 1194740787 | $98 |
| 8 | 1083639926 | $4 |
| 9 | 1073507711 | $0 |
Showing top 9 of 9 providers billing this code