86038
HCPCS Procedure Code
HCPCS code 86038 is the #1,109 most-billed Medicaid procedure code, with $40.3M in payments across 6.3M claims from 2018–2024. The national median cost per claim is $7.96.
Total Paid
$40.3M
0.00% of all spending
Total Claims
6.3M
Providers
1,878
Avg Cost/Claim
$6
National Cost Distribution
How much do providers bill per claim for 86038? Based on 1,766 providers billing this code nationally.
Median
$7.96
Average
$9.67
Std Dev
$13.51
Max
$392.97
Percentile Distribution (Cost per Claim)
50% of providers bill between $4.91 and $11.39 per claim for this code.
90% bill between $1.89 and $15.59.
Top 1% bill above $41.68.
About This Procedure
HCPCS code 86038 was billed by 1,878 providers across 6.3M claims, totaling $40.3M in Medicaid payments from 2018–2024. This code was used for 6.0M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$7.96
Providers Billing
1,766
National Spending
$40.3M
Avg/Median Ratio
1.21×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86038
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $2.4M |
| 2 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $2.2M |
| 3 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $2.0M |
| 4 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $1.3M |
| 5 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $1.3M |
| 6 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $877K |
| 7 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $789K |
| 8 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $768K |
| 9 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $764K |
| 10 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $754K |
| 11 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $716K |
| 12 | Alaska Native Tribal Health Consortium Anchorage, AK · General Acute Care Hospital | $699K |
| 13 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $679K |
| 14 | 1972625499 | $604K |
| 15 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $559K |
| 16 | Laboratory Corporation Of America Phoenix, AZ · Clinical Medical Laboratory | $500K |
| 17 | Laboratory Corporation Of America Seattle, WA · Clinical Medical Laboratory | $475K |
| 18 | Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory | $425K |
| 19 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $392K |
| 20 | Quest Diagnostics Llc Marlborough, MA · Clinical Medical Laboratory | $375K |
Showing top 20 of 1,878 providers billing this code