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#3414 of 11K

86381

HCPCS Procedure Code

HCPCS code 86381 is the #3,414 most-billed Medicaid procedure code, with $1.7M in payments across 172K claims from 2018–2024. The national median cost per claim is $12.14.

Total Paid

$1.7M

0.00% of all spending

Total Claims

172K

Providers

131

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for 86381? Based on 124 providers billing this code nationally.

Median

$12.14

Average

$12.81

Std Dev

$8.16

Max

$57.86

Percentile Distribution (Cost per Claim)

p10
$3.78
p25
$7.60
Median
$12.14
p75
$16.52
p90
$21.93
p95
$25.07
p99
$33.02

50% of providers bill between $7.60 and $16.52 per claim for this code.

90% bill between $3.78 and $21.93.

Top 1% bill above $33.02.

About This Procedure

HCPCS code 86381 was billed by 131 providers across 172K claims, totaling $1.7M in Medicaid payments from 2018–2024. This code was used for 164K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.14

Providers Billing

124

National Spending

$1.7M

Avg/Median Ratio

1.06×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86381

#ProviderTotal Paid
1Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$190K
2Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$134K
3Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$129K
4Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$114K
5Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$84K
6Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$75K
7Quest Diagnostics Clinical Laboratories Inc

Irving, TX · Clinical Medical Laboratory

$72K
8Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$69K
9Laboratory Corporation Of America

San Diego, CA · Clinical Medical Laboratory

$50K
10Quest Diagnostics Llc Il

Wood Dale, IL · Clinical Medical Laboratory

$42K
11Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$39K
12Quest Diagnostics Clinical Laboratories Inc

Tucker, GA · Clinical Medical Laboratory

$35K
131316983158$33K
14Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$32K
15Laboratory Corporation Of America Holdings

Birmingham, AL · Clinical Medical Laboratory

$31K
16Laboratory Corporation Of America

Tampa, FL · Clinical Medical Laboratory

$29K
17Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$27K
18Laboratory Corporation Of America

Seattle, WA · Clinical Medical Laboratory

$27K
19Mayo Collaborative Services, Inc

Rochester, MN · Clinical Medical Laboratory

$25K
201376548271$24K

Showing top 20 of 131 providers billing this code