86901
HCPCS Procedure Code
HCPCS code 86901 is the #846 most-billed Medicaid procedure code, with $68.0M in payments across 16.3M claims from 2018–2024. The national median cost per claim is $2.26. Costs vary widely — the 90th percentile is $14.60 per claim, 6.5× the median.
Total Paid
$68.0M
0.01% of all spending
Total Claims
16.3M
Providers
4K
Avg Cost/Claim
$4
National Cost Distribution
How much do providers bill per claim for 86901? Based on 4K providers billing this code nationally.
Median
$2.26
Average
$5.43
Std Dev
$16.42
Max
$699.62
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.79 and $4.05 per claim for this code.
90% bill between $0.20 and $14.60.
Top 1% bill above $49.94.
About This Procedure
HCPCS code 86901 was billed by 4K providers across 16.3M claims, totaling $68.0M in Medicaid payments from 2018–2024. This code was used for 14.0M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$2.26
Providers Billing
4K
National Spending
$68.0M
Avg/Median Ratio
2.40×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 86901
| # | Provider | Total Paid |
|---|---|---|
| 1 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $1.9M |
| 2 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $1.3M |
| 3 | Women & Infants Hospital Of Rhode Island Providence, RI · Clinic/Center, Ambulatory Family Planning Facility | $1.1M |
| 4 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $893K |
| 5 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $857K |
| 6 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $788K |
| 7 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $778K |
| 8 | 1477549756 | $740K |
| 9 | 1649299827 | $681K |
| 10 | Newyork-presbyterian-queens Flushing, NY · General Acute Care Hospital | $593K |
| 11 | Mount Sinai Hospital New York, NY · Ambulance | $590K |
| 12 | Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital | $578K |
| 13 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $496K |
| 14 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $475K |
| 15 | 1932280666 | $443K |
| 16 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $421K |
| 17 | Truman Medical Center, Incorporated Kansas City, MO · General Acute Care Hospital | $404K |
| 18 | 1902865355 | $387K |
| 19 | New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine | $377K |
| 20 | 1376577247 | $374K |
Showing top 20 of 4K providers billing this code