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#4761 of 11K

86316

HCPCS Procedure Code

HCPCS code 86316 is the #4,761 most-billed Medicaid procedure code, with $416K in payments across 45K claims from 2018–2024. The national median cost per claim is $8.46.

Total Paid

$416K

0.00% of all spending

Total Claims

45K

Providers

66

Avg Cost/Claim

$9

National Cost Distribution

How much do providers bill per claim for 86316? Based on 63 providers billing this code nationally.

Median

$8.46

Average

$9.38

Std Dev

$5.52

Max

$24.99

Percentile Distribution (Cost per Claim)

p10
$3.17
p25
$5.86
Median
$8.46
p75
$13.82
p90
$16.54
p95
$18.14
p99
$23.05

50% of providers bill between $5.86 and $13.82 per claim for this code.

90% bill between $3.17 and $16.54.

Top 1% bill above $23.05.

About This Procedure

HCPCS code 86316 was billed by 66 providers across 45K claims, totaling $416K in Medicaid payments from 2018–2024. This code was used for 40K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$8.46

Providers Billing

63

National Spending

$416K

Avg/Median Ratio

1.11×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86316

#ProviderTotal Paid
1City Of Hope National Medical Center

Duarte, CA · General Acute Care Hospital

$123K
2Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$47K
31780620526$27K
41891873303$23K
5Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$23K
6Bronxcare Health System

Bronx, NY · General Acute Care Hospital

$22K
7Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$20K
81376548271$20K
9Froedtert Memorial Lutheran Hospital, Inc.

Milwaukee, WI · Clinic/Center, Radiology

$13K
10Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$12K
11Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$10K
12Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$10K
13Accu Reference Medical Lab, Llc

Linden, NJ · Clinical Medical Laboratory

$7K
14Berkshire Medical Center, Inc

Pittsfield, MA · General Acute Care Hospital

$7K
15Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$5K
161295856904$5K
17Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$5K
18Arthur G James Cancer Hospital And Research Institute

Columbus, OH · Special Hospital

$4K
19Mayo Collaborative Services, Inc

Rochester, MN · Clinical Medical Laboratory

$3K
201073587937$3K

Showing top 20 of 66 providers billing this code