Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#7093 of 11K

86051

HCPCS Procedure Code

HCPCS code 86051 is the #7,093 most-billed Medicaid procedure code, with $29K in payments across 1,781 claims from 2018–2024. The national median cost per claim is $14.34.

Total Paid

$29K

0.00% of all spending

Total Claims

1,781

Providers

3

Avg Cost/Claim

$16

National Cost Distribution

How much do providers bill per claim for 86051? Based on 2 providers billing this code nationally.

Median

$14.34

Average

$14.34

Std Dev

$3.19

Max

$16.60

Percentile Distribution (Cost per Claim)

p10
$12.54
p25
$13.22
Median
$14.34
p75
$15.47
p90
$16.15
p95
$16.37
p99
$16.55

50% of providers bill between $13.22 and $15.47 per claim for this code.

90% bill between $12.54 and $16.15.

Top 1% bill above $16.55.

About This Procedure

HCPCS code 86051 was billed by 3 providers across 1,781 claims, totaling $29K in Medicaid payments from 2018–2024. This code was used for 1,633 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$14.34

Providers Billing

2

National Spending

$29K

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.