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#7842 of 11K

86294

HCPCS Procedure Code

HCPCS code 86294 is the #7,842 most-billed Medicaid procedure code, with $9K in payments across 4K claims from 2018–2024. The national median cost per claim is $7.36.

Total Paid

$9K

0.00% of all spending

Total Claims

4K

Providers

2

Avg Cost/Claim

$3

National Cost Distribution

How much do providers bill per claim for 86294? Based on 2 providers billing this code nationally.

Median

$7.36

Average

$7.36

Std Dev

$6.93

Max

$12.26

Percentile Distribution (Cost per Claim)

p10
$3.44
p25
$4.91
Median
$7.36
p75
$9.81
p90
$11.28
p95
$11.77
p99
$12.17

50% of providers bill between $4.91 and $9.81 per claim for this code.

90% bill between $3.44 and $11.28.

Top 1% bill above $12.17.

About This Procedure

HCPCS code 86294 was billed by 2 providers across 4K claims, totaling $9K in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.36

Providers Billing

2

National Spending

$9K

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.