86361
HCPCS Procedure Code
HCPCS code 86361 is the #1,902 most-billed Medicaid procedure code, with $11.9M in payments across 900K claims from 2018–2024. The national median cost per claim is $16.50.
Total Paid
$11.9M
0.00% of all spending
Total Claims
900K
Providers
256
Avg Cost/Claim
$13
National Cost Distribution
How much do providers bill per claim for 86361? Based on 228 providers billing this code nationally.
Median
$16.50
Average
$17.71
Std Dev
$12.08
Max
$97.64
Percentile Distribution (Cost per Claim)
50% of providers bill between $10.28 and $24.31 per claim for this code.
90% bill between $3.66 and $28.88.
Top 1% bill above $61.82.
About This Procedure
HCPCS code 86361 was billed by 256 providers across 900K claims, totaling $11.9M in Medicaid payments from 2018–2024. This code was used for 845K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$16.50
Providers Billing
228
National Spending
$11.9M
Avg/Median Ratio
1.07×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86361
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $1.5M |
| 2 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $577K |
| 3 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $556K |
| 4 | Laboratory Corporation Of America San Diego, CA · Clinical Medical Laboratory | $530K |
| 5 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $491K |
| 6 | Mount Sinai Hospital New York, NY · Ambulance | $430K |
| 7 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $406K |
| 8 | St Lukes Roosevelt Hospital Center New York, NY · Case Management | $403K |
| 9 | Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory | $362K |
| 10 | 1447477252 | $360K |
| 11 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $329K |
| 12 | Beth Israel Medical Center Brooklyn, NY · Psychiatric Unit | $271K |
| 13 | Quest Diagnostics Incorporated Md Baltimore, MD · Clinical Medical Laboratory | $214K |
| 14 | University Hospital Newark, NJ · General Acute Care Hospital | $202K |
| 15 | 1447233861 | $201K |
| 16 | Quest Diagnostics Massachusetts Llc Marlborough, MA · Clinical Medical Laboratory | $191K |
| 17 | Dallas County Hospital District Dallas, TX · Clinic/Center, Ambulatory Surgical | $175K |
| 18 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $164K |
| 19 | 1740265347 | $151K |
| 20 | 1629109137 | $150K |
Showing top 20 of 256 providers billing this code