Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1839 of 11K

86902

HCPCS Procedure Code

HCPCS code 86902 is the #1,839 most-billed Medicaid procedure code, with $13.0M in payments across 160K claims from 2018–2024. The national median cost per claim is $24.83. Costs vary widely — the 90th percentile is $169.97 per claim, 6.8× the median.

Total Paid

$13.0M

0.00% of all spending

Total Claims

160K

Providers

121

Avg Cost/Claim

$81

National Cost Distribution

How much do providers bill per claim for 86902? Based on 121 providers billing this code nationally.

Median

$24.83

Average

$60.42

Std Dev

$106.28

Max

$594.45

Percentile Distribution (Cost per Claim)

p10
$3.36
p25
$8.63
Median
$24.83
p75
$48.06
p90
$169.97
p95
$284.29
p99
$513.56

50% of providers bill between $8.63 and $48.06 per claim for this code.

90% bill between $3.36 and $169.97.

Top 1% bill above $513.56.

About This Procedure

HCPCS code 86902 was billed by 121 providers across 160K claims, totaling $13.0M in Medicaid payments from 2018–2024. This code was used for 103K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$24.83

Providers Billing

121

National Spending

$13.0M

Avg/Median Ratio

2.43×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 86902

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

Jackson, MS · General Acute Care Hospital

$6.1M
2Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$1.8M
3Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$961K
4Children's Health System Of Texas

Dallas, TX · General Acute Care Hospital Children

$549K
5St. Barnabas Hospital

Bronx, NY · General Acute Care Hospital

$388K
6Childrens Hospital Of Philadelphia

Philadelphia, PA · General Acute Care Hospital Children

$315K
7Children's Hospital & Research Center At Oakland

Oakland, CA · General Acute Care Hospital

$214K
8Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$176K
9Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$152K
10Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$148K
111427360700$124K
12Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$120K
13Childrens Hospital Of The Kings Daughters Inc

Norfolk, VA · Social Worker, Clinical

$107K
14Arkansas Childrens Hospital

Little Rock, AR · Clinic/Center, Critical Access Hospital

$106K
151558365890$93K
16The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$92K
17Froedtert Memorial Lutheran Hospital, Inc.

Milwaukee, WI · Clinic/Center, Radiology

$86K
18Vhs Childrens Hospital Of Michigan Inc

Detroit, MI · Clinic/Center, Ambulatory Surgical

$84K
191366459570$74K
20Newark Beth Israel Medical Center Inc

Newark, NJ · General Acute Care Hospital

$71K

Showing top 20 of 121 providers billing this code