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#6243 of 11K

86366

HCPCS Procedure Code

HCPCS code 86366 is the #6,243 most-billed Medicaid procedure code, with $81K in payments across 1,212 claims from 2018–2024. The national median cost per claim is $18.11. Costs vary widely — the 90th percentile is $110.74 per claim, 6.1× the median.

Total Paid

$81K

0.00% of all spending

Total Claims

1,212

Providers

9

Avg Cost/Claim

$67

National Cost Distribution

How much do providers bill per claim for 86366? Based on 9 providers billing this code nationally.

Median

$18.11

Average

$54.08

Std Dev

$97.43

Max

$308.92

Percentile Distribution (Cost per Claim)

p10
$7.74
p25
$11.02
Median
$18.11
p75
$45.18
p90
$110.74
p95
$209.83
p99
$289.10

50% of providers bill between $11.02 and $45.18 per claim for this code.

90% bill between $7.74 and $110.74.

Top 1% bill above $289.10.

About This Procedure

HCPCS code 86366 was billed by 9 providers across 1,212 claims, totaling $81K in Medicaid payments from 2018–2024. This code was used for 1,156 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$18.11

Providers Billing

9

National Spending

$81K

Avg/Median Ratio

2.99×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 86366

#ProviderTotal Paid
1Permanente Medical Group, Inc.

Richmond, CA · Clinical Medical Laboratory

$41K
2Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$27K
31891873303$7K
41962489237$2K
5Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$1K
6Laboratory Corporation Of America

San Diego, CA · Clinical Medical Laboratory

$543
7Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$282
8Mayo Collaborative Services, Inc

Rochester, MN · Clinical Medical Laboratory

$150
9Quest Diagnostics Incorporated

Las Vegas, NV · Clinical Medical Laboratory

$47

Showing top 9 of 9 providers billing this code