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#2595 of 11K

86357

HCPCS Procedure Code

HCPCS code 86357 is the #2,595 most-billed Medicaid procedure code, with $4.7M in payments across 290K claims from 2018–2024. The national median cost per claim is $18.27.

Total Paid

$4.7M

0.00% of all spending

Total Claims

290K

Providers

180

Avg Cost/Claim

$16

National Cost Distribution

How much do providers bill per claim for 86357? Based on 175 providers billing this code nationally.

Median

$18.27

Average

$19.62

Std Dev

$14.73

Max

$89.45

Percentile Distribution (Cost per Claim)

p10
$2.87
p25
$9.04
Median
$18.27
p75
$27.06
p90
$33.36
p95
$44.72
p99
$76.97

50% of providers bill between $9.04 and $27.06 per claim for this code.

90% bill between $2.87 and $33.36.

Top 1% bill above $76.97.

About This Procedure

HCPCS code 86357 was billed by 180 providers across 290K claims, totaling $4.7M in Medicaid payments from 2018–2024. This code was used for 269K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$18.27

Providers Billing

175

National Spending

$4.7M

Avg/Median Ratio

1.07×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86357

#ProviderTotal Paid
1Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$1.5M
2University Of Kentucky

Lexington, KY · General Acute Care Hospital

$254K
3Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$200K
4Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$156K
51568488450$114K
6The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$114K
7Permanente Medical Group, Inc.

Richmond, CA · Clinical Medical Laboratory

$95K
8Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$89K
9Accu Reference Medical Lab, Llc

Linden, NJ · Clinical Medical Laboratory

$85K
10Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$80K
11Baystate Medical Center Inc

Springfield, MA · General Acute Care Hospital

$73K
12Children's Hospital Corporation

Boston, MA · Clinic/Center

$70K
13Newark Beth Israel Medical Center Inc

Newark, NJ · General Acute Care Hospital

$67K
14Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$65K
151922008150$62K
16Childrens Hospital Of Philadelphia

Philadelphia, PA · General Acute Care Hospital Children

$62K
171598875460$59K
18Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$56K
19Quest Diagnostics Incorporated

Las Vegas, NV · Clinical Medical Laboratory

$52K
20Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$51K

Showing top 20 of 180 providers billing this code