86870
HCPCS Procedure Code
HCPCS code 86870 is the #2,527 most-billed Medicaid procedure code, with $5.1M in payments across 246K claims from 2018–2024. The national median cost per claim is $13.22. Costs vary widely — the 90th percentile is $77.60 per claim, 5.9× the median.
Total Paid
$5.1M
0.00% of all spending
Total Claims
246K
Providers
333
Avg Cost/Claim
$21
National Cost Distribution
How much do providers bill per claim for 86870? Based on 322 providers billing this code nationally.
Median
$13.22
Average
$28.83
Std Dev
$42.66
Max
$270.02
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.58 and $31.64 per claim for this code.
90% bill between $2.28 and $77.60.
Top 1% bill above $204.36.
About This Procedure
HCPCS code 86870 was billed by 333 providers across 246K claims, totaling $5.1M in Medicaid payments from 2018–2024. This code was used for 217K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$13.22
Providers Billing
322
National Spending
$5.1M
Avg/Median Ratio
2.18×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 86870
| # | Provider | Total Paid |
|---|---|---|
| 1 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $346K |
| 2 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $296K |
| 3 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $296K |
| 4 | Women & Infants Hospital Of Rhode Island Providence, RI · Clinic/Center, Ambulatory Family Planning Facility | $252K |
| 5 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $221K |
| 6 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $189K |
| 7 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $187K |
| 8 | Henry Ford Health System Detroit, MI · General Acute Care Hospital | $130K |
| 9 | Spectrum Health Hospitals Grand Rapids, MI · General Acute Care Hospital | $123K |
| 10 | Laboratory Corporation Of America Seattle, WA · Clinical Medical Laboratory | $120K |
| 11 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $110K |
| 12 | Hartford Hospital Hartford, CT · General Acute Care Hospital | $107K |
| 13 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $99K |
| 14 | Saint Francis Hospital And Medical Center Hartford, CT · General Acute Care Hospital | $95K |
| 15 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $77K |
| 16 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $77K |
| 17 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $75K |
| 18 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $75K |
| 19 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $71K |
| 20 | 1427360700 | $62K |
Showing top 20 of 333 providers billing this code