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#7615 of 11K

86052

HCPCS Procedure Code

HCPCS code 86052 is the #7,615 most-billed Medicaid procedure code, with $13K in payments across 925 claims from 2018–2024. The national median cost per claim is $11.42. Costs vary widely — the 90th percentile is $24.79 per claim, 2.2× the median.

Total Paid

$13K

0.00% of all spending

Total Claims

925

Providers

4

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for 86052? Based on 4 providers billing this code nationally.

Median

$11.42

Average

$13.40

Std Dev

$11.65

Max

$28.72

Percentile Distribution (Cost per Claim)

p10
$3.59
p25
$5.93
Median
$11.42
p75
$18.88
p90
$24.79
p95
$26.75
p99
$28.33

50% of providers bill between $5.93 and $18.88 per claim for this code.

90% bill between $3.59 and $24.79.

Top 1% bill above $28.33.

About This Procedure

HCPCS code 86052 was billed by 4 providers across 925 claims, totaling $13K in Medicaid payments from 2018–2024. This code was used for 866 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.42

Providers Billing

4

National Spending

$13K

Avg/Median Ratio

1.17×

Normal distribution

Provider Coverage

We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.