86043
HCPCS Procedure Code
HCPCS code 86043 is the #7,297 most-billed Medicaid procedure code, with $22K in payments across 2,109 claims from 2018–2024. The national median cost per claim is $5.88. Costs vary widely — the 90th percentile is $13.04 per claim, 2.2× the median.
Total Paid
$22K
0.00% of all spending
Total Claims
2,109
Providers
10
Avg Cost/Claim
$10
National Cost Distribution
How much do providers bill per claim for 86043? Based on 9 providers billing this code nationally.
Median
$5.88
Average
$6.66
Std Dev
$5.45
Max
$16.99
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.24 and $10.67 per claim for this code.
90% bill between $1.94 and $13.04.
Top 1% bill above $16.60.
About This Procedure
HCPCS code 86043 was billed by 10 providers across 2,109 claims, totaling $22K in Medicaid payments from 2018–2024. This code was used for 1,977 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$5.88
Providers Billing
9
National Spending
$22K
Avg/Median Ratio
1.13×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86043
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $15K |
| 2 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $3K |
| 3 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $2K |
| 4 | 1780620526 | $1K |
| 5 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $189 |
| 6 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $89 |
| 7 | Laboratory Corporation Of America Phoenix, AZ · Clinical Medical Laboratory | $89 |
| 8 | Quest Diagnostics Incorporated Las Vegas, NV · Clinical Medical Laboratory | $74 |
| 9 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $33 |
| 10 | Laboratory Corporation Of America San Diego, CA · Clinical Medical Laboratory | $0 |
Showing top 10 of 10 providers billing this code