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#4335 of 11K

86037

HCPCS Procedure Code

HCPCS code 86037 is the #4,335 most-billed Medicaid procedure code, with $654K in payments across 70K claims from 2018–2024. The national median cost per claim is $8.15. Costs vary widely — the 90th percentile is $22.57 per claim, 2.8× the median.

Total Paid

$654K

0.00% of all spending

Total Claims

70K

Providers

42

Avg Cost/Claim

$9

National Cost Distribution

How much do providers bill per claim for 86037? Based on 42 providers billing this code nationally.

Median

$8.15

Average

$10.06

Std Dev

$8.11

Max

$31.89

Percentile Distribution (Cost per Claim)

p10
$1.81
p25
$3.73
Median
$8.15
p75
$12.87
p90
$22.57
p95
$26.75
p99
$31.63

50% of providers bill between $3.73 and $12.87 per claim for this code.

90% bill between $1.81 and $22.57.

Top 1% bill above $31.63.

About This Procedure

HCPCS code 86037 was billed by 42 providers across 70K claims, totaling $654K in Medicaid payments from 2018–2024. This code was used for 63K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$8.15

Providers Billing

42

National Spending

$654K

Avg/Median Ratio

1.23×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86037

#ProviderTotal Paid
1Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$279K
2Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$121K
3Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$62K
4Laboratory Corporation Of America

Tampa, FL · Clinical Medical Laboratory

$31K
5Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$28K
6Laboratory Corporation Of America

San Diego, CA · Clinical Medical Laboratory

$22K
7Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$16K
8Laboratory Corporation Of America

Seattle, WA · Clinical Medical Laboratory

$16K
9Laboratory Corporation Of America Holdings

Birmingham, AL · Clinical Medical Laboratory

$13K
10Laboratory Corporation Of America

Phoenix, AZ · Clinical Medical Laboratory

$9K
111649767948$8K
121104829159$7K
131245494517$6K
14Laboratory Corporation Of America

Houston, TX · Clinical Medical Laboratory

$5K
15Ohio State University Hospitals

Columbus, OH · General Acute Care Hospital

$5K
16University Of Cincinnati Medical Center, Llc

Cincinnati, OH · General Acute Care Hospital

$4K
17Sherman Abrams Laboratory Inc

Brooklyn, NY · Clinical Medical Laboratory

$4K
181699858373$2K
19Empire City Laboratories, Inc

Brooklyn, NY · Clinical Medical Laboratory

$2K
201811524572$2K

Showing top 20 of 42 providers billing this code