86364
HCPCS Procedure Code
HCPCS code 86364 is the #1,974 most-billed Medicaid procedure code, with $10.7M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $8.59. Costs vary widely — the 90th percentile is $19.31 per claim, 2.2× the median.
Total Paid
$10.7M
0.00% of all spending
Total Claims
1.1M
Providers
511
Avg Cost/Claim
$9
National Cost Distribution
How much do providers bill per claim for 86364? Based on 486 providers billing this code nationally.
Median
$8.59
Average
$10.94
Std Dev
$11.78
Max
$123.65
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.57 and $11.96 per claim for this code.
90% bill between $2.49 and $19.31.
Top 1% bill above $66.61.
About This Procedure
HCPCS code 86364 was billed by 511 providers across 1.1M claims, totaling $10.7M in Medicaid payments from 2018–2024. This code was used for 1.1M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$8.59
Providers Billing
486
National Spending
$10.7M
Avg/Median Ratio
1.27×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86364
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $813K |
| 2 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $766K |
| 3 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $597K |
| 4 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $534K |
| 5 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $437K |
| 6 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $368K |
| 7 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $333K |
| 8 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $315K |
| 9 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $288K |
| 10 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $269K |
| 11 | 1316983158 | $250K |
| 12 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $250K |
| 13 | Quest Diagnostics Llc Marlborough, MA · Clinical Medical Laboratory | $223K |
| 14 | Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory | $203K |
| 15 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $178K |
| 16 | Mayo Collaborative Services, Inc Rochester, MN · Clinical Medical Laboratory | $172K |
| 17 | Laboratory Corporation Of America Seattle, WA · Clinical Medical Laboratory | $145K |
| 18 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $142K |
| 19 | 1083249577 | $129K |
| 20 | Children's Hospital & Research Center At Oakland Oakland, CA · General Acute Care Hospital | $125K |
Showing top 20 of 511 providers billing this code