86256
HCPCS Procedure Code
HCPCS code 86256 is the #2,897 most-billed Medicaid procedure code, with $3.1M in payments across 276K claims from 2018–2024. The national median cost per claim is $9.40. Costs vary widely — the 90th percentile is $19.31 per claim, 2.1× the median.
Total Paid
$3.1M
0.00% of all spending
Total Claims
276K
Providers
273
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for 86256? Based on 266 providers billing this code nationally.
Median
$9.40
Average
$10.91
Std Dev
$9.12
Max
$58.55
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.57 and $13.44 per claim for this code.
90% bill between $2.49 and $19.31.
Top 1% bill above $53.10.
About This Procedure
HCPCS code 86256 was billed by 273 providers across 276K claims, totaling $3.1M in Medicaid payments from 2018–2024. This code was used for 253K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$9.40
Providers Billing
266
National Spending
$3.1M
Avg/Median Ratio
1.16×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86256
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $693K |
| 2 | 1891873303 | $263K |
| 3 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $235K |
| 4 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $156K |
| 5 | 1801874573 | $90K |
| 6 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $89K |
| 7 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $74K |
| 8 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $62K |
| 9 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $61K |
| 10 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $51K |
| 11 | 1376548271 | $51K |
| 12 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $46K |
| 13 | Multicare Health System Tacoma, WA · Community/Behavioral Health | $43K |
| 14 | Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital | $37K |
| 15 | 1649767948 | $37K |
| 16 | Laboratory Corporation Of America San Diego, CA · Clinical Medical Laboratory | $37K |
| 17 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $34K |
| 18 | Accurate Diagnostics Labs, Inc. South Plainfield, NJ · Clinical Medical Laboratory | $32K |
| 19 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $31K |
| 20 | 1861404121 | $30K |
Showing top 20 of 273 providers billing this code