#986 of 11K

87806

HCPCS Procedure Code

HCPCS code 87806 is the #986 most-billed Medicaid procedure code, with $50.9M in payments across 2.4M claims from 2018–2024. The national median cost per claim is $20.54.

Total Paid

$50.9M

0.00% of all spending

Total Claims

2.4M

Providers

691

Avg Cost/Claim

$21

National Cost Distribution

How much do providers bill per claim for 87806? Based on 644 providers billing this code nationally.

Median

$20.54

Average

$20.54

Std Dev

$13.12

Max

$172.85

Percentile Distribution (Cost per Claim)

p10

$4.98

p25

$15.67

Median

$20.54

p75

$25.27

p90

$27.55

p95

$34.25

p99

$71.86

50% of providers bill between $15.67 and $25.27 per claim for this code.

90% bill between $4.98 and $27.55.

Top 1% bill above $71.86.

About This Procedure

HCPCS code 87806 was billed by 691 providers across 2.4M claims, totaling $50.9M in Medicaid payments from 2018–2024. This code was used for 2.1M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$20.54

Providers Billing

644

National Spending

$50.9M

Avg/Median Ratio

1.00×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87806

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Planned Parenthood/orange And San Bernardino Counties, Inc. Orange, CA · Clinic/Center, Ambulatory Family Planning Facility	$5.1M	$23.72	1.2× median	Above Median
2	1881626943	$2.7M	$11.11	0.5× median	Below Median
3	1629057146	$1.4M	$28.30	1.4× median	Top 10%
4	1336174325	$1.3M	$25.82	1.3× median	Above 75th
5	1700913118	$1.2M	$24.40	1.2× median	Above Median
6	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$1.0M	$18.32	0.9× median	Below Median
7	1073669040	$810K	$18.56	0.9× median	Below Median
8	1497780480	$802K	$23.70	1.2× median	Above Median
9	1033144027	$764K	$22.24	1.1× median	Above Median
10	1750316741	$754K	$23.93	1.2× median	Above Median
11	1851692560	$697K	$27.29	1.3× median	Above 75th
12	1639218548	$677K	$17.55	0.9× median	Below Median
13	1255366241	$633K	$24.67	1.2× median	Above Median
14	1982763090	$550K	$24.62	1.2× median	Above Median
15	1427081652	$540K	$25.35	1.2× median	Above 75th
16	1144369059	$524K	$20.10	1.0× median	Below Median
17	1245257708	$495K	$25.23	1.2× median	Above Median
18	1770641482	$469K	$23.84	1.2× median	Above Median
19	1659671600	$456K	$25.92	1.3× median	Above 75th
20	1740505262	$455K	$22.86	1.1× median	Above Median

Showing top 20 of 691 providers billing this code

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