86042
HCPCS Procedure Code
HCPCS code 86042 is the #7,153 most-billed Medicaid procedure code, with $27K in payments across 2,161 claims from 2018–2024. The national median cost per claim is $9.68.
Total Paid
$27K
0.00% of all spending
Total Claims
2,161
Providers
9
Avg Cost/Claim
$12
National Cost Distribution
How much do providers bill per claim for 86042? Based on 8 providers billing this code nationally.
Median
$9.68
Average
$9.27
Std Dev
$4.70
Max
$14.67
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.29 and $12.98 per claim for this code.
90% bill between $4.20 and $14.42.
Top 1% bill above $14.65.
About This Procedure
HCPCS code 86042 was billed by 9 providers across 2,161 claims, totaling $27K in Medicaid payments from 2018–2024. This code was used for 2,040 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$9.68
Providers Billing
8
National Spending
$27K
Avg/Median Ratio
0.96×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86042
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $20K |
| 2 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $2K |
| 3 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $2K |
| 4 | 1780620526 | $2K |
| 5 | 1376548271 | $644 |
| 6 | Laboratory Corporation Of America Phoenix, AZ · Clinical Medical Laboratory | $289 |
| 7 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $183 |
| 8 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $82 |
| 9 | Laboratory Corporation Of America San Diego, CA · Clinical Medical Laboratory | $0 |
Showing top 9 of 9 providers billing this code