86255
HCPCS Procedure Code
HCPCS code 86255 is the #2,259 most-billed Medicaid procedure code, with $7.3M in payments across 944K claims from 2018–2024. The national median cost per claim is $8.82. Costs vary widely — the 90th percentile is $20.39 per claim, 2.3× the median.
Total Paid
$7.3M
0.00% of all spending
Total Claims
944K
Providers
564
Avg Cost/Claim
$8
National Cost Distribution
How much do providers bill per claim for 86255? Based on 536 providers billing this code nationally.
Median
$8.82
Average
$11.27
Std Dev
$14.04
Max
$232.88
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.11 and $13.82 per claim for this code.
90% bill between $2.67 and $20.39.
Top 1% bill above $51.40.
About This Procedure
HCPCS code 86255 was billed by 564 providers across 944K claims, totaling $7.3M in Medicaid payments from 2018–2024. This code was used for 805K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$8.82
Providers Billing
536
National Spending
$7.3M
Avg/Median Ratio
1.28×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86255
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $665K |
| 2 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $359K |
| 3 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $332K |
| 4 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $278K |
| 5 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $190K |
| 6 | Mayo Collaborative Services, Inc Rochester, MN · Clinical Medical Laboratory | $170K |
| 7 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $164K |
| 8 | Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children | $160K |
| 9 | 1891873303 | $142K |
| 10 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $130K |
| 11 | 1871606269 | $129K |
| 12 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $125K |
| 13 | 1780620526 | $124K |
| 14 | 1245382753 | $98K |
| 15 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $98K |
| 16 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $94K |
| 17 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $92K |
| 18 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $91K |
| 19 | 1447296272 | $86K |
| 20 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $83K |
Showing top 20 of 564 providers billing this code