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#4612 of 11K

86063

HCPCS Procedure Code

HCPCS code 86063 is the #4,612 most-billed Medicaid procedure code, with $488K in payments across 111K claims from 2018–2024. The national median cost per claim is $2.52. Costs vary widely — the 90th percentile is $6.10 per claim, 2.4× the median.

Total Paid

$488K

0.00% of all spending

Total Claims

111K

Providers

59

Avg Cost/Claim

$4

National Cost Distribution

How much do providers bill per claim for 86063? Based on 50 providers billing this code nationally.

Median

$2.52

Average

$4.38

Std Dev

$10.15

Max

$65.43

Percentile Distribution (Cost per Claim)

p10
$0.24
p25
$0.52
Median
$2.52
p75
$4.31
p90
$6.10
p95
$6.27
p99
$50.62

50% of providers bill between $0.52 and $4.31 per claim for this code.

90% bill between $0.24 and $6.10.

Top 1% bill above $50.62.

About This Procedure

HCPCS code 86063 was billed by 59 providers across 111K claims, totaling $488K in Medicaid payments from 2018–2024. This code was used for 97K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$2.52

Providers Billing

50

National Spending

$488K

Avg/Median Ratio

1.74×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 86063

#ProviderTotal Paid
11972625499$281K
21902844194$67K
31144202003$35K
41265546048$25K
51245275106$18K
6Lenco Diagnostic Laboratories,inc.

Brooklyn, NY · Clinical Medical Laboratory

$18K
71750332565$12K
8State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$7K
9Sunrise Medical Laboratories, Inc.

Hicksville, NY · Clinical Medical Laboratory

$6K
101902416936$5K
111033201090$1K
121700913118$1K
131700120318$1K
141790939643$925
151043649155$861
161821091067$797
171306585328$781
181407861990$729
191134606171$708
201144228347$652

Showing top 20 of 59 providers billing this code

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