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#4566 of 11K

86320

HCPCS Procedure Code

HCPCS code 86320 is the #4,566 most-billed Medicaid procedure code, with $511K in payments across 48K claims from 2018–2024. The national median cost per claim is $9.68. Costs vary widely — the 90th percentile is $25.85 per claim, 2.7× the median.

Total Paid

$511K

0.00% of all spending

Total Claims

48K

Providers

40

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for 86320? Based on 36 providers billing this code nationally.

Median

$9.68

Average

$13.19

Std Dev

$10.69

Max

$41.79

Percentile Distribution (Cost per Claim)

p10
$1.40
p25
$5.07
Median
$9.68
p75
$23.75
p90
$25.85
p95
$28.37
p99
$38.35

50% of providers bill between $5.07 and $23.75 per claim for this code.

90% bill between $1.40 and $25.85.

Top 1% bill above $38.35.

About This Procedure

HCPCS code 86320 was billed by 40 providers across 48K claims, totaling $511K in Medicaid payments from 2018–2024. This code was used for 45K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.68

Providers Billing

36

National Spending

$511K

Avg/Median Ratio

1.36×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86320

#ProviderTotal Paid
1Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$149K
21801874573$120K
3Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$53K
41669499414$48K
5Pikeville Medical Center Inc

Pikeville, KY · General Acute Care Hospital

$25K
61447255153$24K
71164402038$16K
81912018094$16K
91841767274$15K
101114079167$12K
111275595449$10K
12Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$4K
131831137512$3K
14New York City Health And Hospitals Corporation

New York, NY · Internal Medicine

$3K
15Svmc Holdings, Inc

Bridgeport, CT · General Acute Care Hospital

$2K
16Tufts Medical Center, Inc.

Boston, MA · General Acute Care Hospital

$2K
171790131050$1K
18New York City Health And Hospitals Corporation

Brooklyn, NY · Internal Medicine

$1K
191194778415$1K
201114984671$855

Showing top 20 of 40 providers billing this code