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#1793 of 11K

86885

HCPCS Procedure Code

HCPCS code 86885 is the #1,793 most-billed Medicaid procedure code, with $13.8M in payments across 523K claims from 2018–2024. The national median cost per claim is $5.28. Costs vary widely — the 90th percentile is $60.86 per claim, 11.5× the median.

Total Paid

$13.8M

0.00% of all spending

Total Claims

523K

Providers

216

Avg Cost/Claim

$26

National Cost Distribution

How much do providers bill per claim for 86885? Based on 204 providers billing this code nationally.

Median

$5.28

Average

$15.80

Std Dev

$24.36

Max

$162.32

Percentile Distribution (Cost per Claim)

p10
$0.89
p25
$2.56
Median
$5.28
p75
$13.83
p90
$60.86
p95
$68.97
p99
$84.69

50% of providers bill between $2.56 and $13.83 per claim for this code.

90% bill between $0.89 and $60.86.

Top 1% bill above $84.69.

About This Procedure

HCPCS code 86885 was billed by 216 providers across 523K claims, totaling $13.8M in Medicaid payments from 2018–2024. This code was used for 452K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.28

Providers Billing

204

National Spending

$13.8M

Avg/Median Ratio

2.99×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 86885

#ProviderTotal Paid
1State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$3.4M
21356496772$715K
3Bronxcare Health System

Bronx, NY · General Acute Care Hospital

$696K
4Kaiser Foundation Hospitals

Downey, CA · General Acute Care Hospital

$598K
51073606901$476K
61821143777$470K
71306876065$467K
81134274897$463K
91013062769$448K
10Kaiser Foundation Hospitals

Baldwin Park, CA · General Acute Care Hospital

$421K
111922079094$406K
121376698043$405K
131336294040$398K
141598875460$397K
151558798603$368K
161306991211$331K
17City Of Hope National Medical Center

Duarte, CA · General Acute Care Hospital

$300K
181699756445$280K
191144213117$176K
201639284409$173K

Showing top 20 of 216 providers billing this code