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#792 of 11K

87486

HCPCS Procedure Code

HCPCS code 87486 is the #792 most-billed Medicaid procedure code, with $79.0M in payments across 3.9M claims from 2018–2024. The national median cost per claim is $19.16. Costs vary widely — the 90th percentile is $41.10 per claim, 2.1× the median.

Total Paid

$79.0M

0.01% of all spending

Total Claims

3.9M

Providers

2K

Avg Cost/Claim

$20

National Cost Distribution

How much do providers bill per claim for 87486? Based on 1K providers billing this code nationally.

Median

$19.16

Average

$24.55

Std Dev

$42.83

Max

$784.90

Percentile Distribution (Cost per Claim)

p10
$1.92
p25
$7.30
Median
$19.16
p75
$29.67
p90
$41.10
p95
$55.07
p99
$166.55

50% of providers bill between $7.30 and $29.67 per claim for this code.

90% bill between $1.92 and $41.10.

Top 1% bill above $166.55.

About This Procedure

HCPCS code 87486 was billed by 2K providers across 3.9M claims, totaling $79.0M in Medicaid payments from 2018–2024. This code was used for 3.4M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$19.16

Providers Billing

1K

National Spending

$79.0M

Avg/Median Ratio

1.28×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87486

#ProviderTotal Paid
1Physicians Group Laboratories, Llc

Houma, LA · Clinical Medical Laboratory

$4.7M
2Healthtrackrx Indiana, Inc

Denton, TX · Clinical Medical Laboratory

$3.9M
3Eurofins Diatherix Laboratories Llc

Huntsville, AL · Clinical Medical Laboratory

$3.8M
4Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$2.6M
5The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$2.4M
61255875746$2.3M
7Sherman Abrams Laboratory Inc

Brooklyn, NY · Clinical Medical Laboratory

$2.3M
8Suny Health Science Center At Syracuse

Syracuse, NY · General Acute Care Hospital

$2.1M
9Arkansas Childrens Hospital

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

$1.3M
101598266421$1.3M
111861900698$1.3M
121649829987$1.2M
13Empire City Laboratories, Inc

Brooklyn, NY · Clinical Medical Laboratory

$1.0M
141417919531$963K
15Doctors Hospital At Renaissance, Ltd

Edinburg, TX · Clinic/Center, Ambulatory Surgical

$943K
16Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$916K
17Accu Reference Medical Lab, Llc

Linden, NJ · Clinical Medical Laboratory

$866K
18The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$858K
191033239413$811K
20Childrens Hospital Of The Kings Daughters Inc

Norfolk, VA · Social Worker, Clinical

$765K

Showing top 20 of 2K providers billing this code