86481
HCPCS Procedure Code
HCPCS code 86481 is the #1,005 most-billed Medicaid procedure code, with $48.7M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $52.45.
Total Paid
$48.7M
0.00% of all spending
Total Claims
1.1M
Providers
409
Avg Cost/Claim
$44
National Cost Distribution
How much do providers bill per claim for 86481? Based on 389 providers billing this code nationally.
Median
$52.45
Average
$55.32
Std Dev
$35.82
Max
$259.02
Percentile Distribution (Cost per Claim)
50% of providers bill between $32.31 and $70.45 per claim for this code.
90% bill between $13.38 and $92.84.
Top 1% bill above $172.25.
About This Procedure
HCPCS code 86481 was billed by 409 providers across 1.1M claims, totaling $48.7M in Medicaid payments from 2018–2024. This code was used for 1.1M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$52.45
Providers Billing
389
National Spending
$48.7M
Avg/Median Ratio
1.05×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86481
| # | Provider | Total Paid |
|---|---|---|
| 1 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $7.9M |
| 2 | Empire City Laboratories, Inc Brooklyn, NY · Clinical Medical Laboratory | $4.3M |
| 3 | Lenco Diagnostic Laboratories,inc. Brooklyn, NY · Clinical Medical Laboratory | $2.5M |
| 4 | 1881626943 | $1.9M |
| 5 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $1.6M |
| 6 | Gravity Diagnostics, Llc Covington, KY · Clinical Medical Laboratory | $1.5M |
| 7 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $1.3M |
| 8 | 1114286523 | $1.1M |
| 9 | 1548208440 | $888K |
| 10 | Jamaica Hospital Richmond Hill, NY · General Acute Care Hospital | $806K |
| 11 | 1336361575 | $777K |
| 12 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $608K |
| 13 | Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital | $604K |
| 14 | Women & Infants Hospital Of Rhode Island Providence, RI · Clinic/Center, Ambulatory Family Planning Facility | $583K |
| 15 | 1881697464 | $562K |
| 16 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $555K |
| 17 | 1619980430 | $482K |
| 18 | 1215048913 | $467K |
| 19 | 1942226006 | $465K |
| 20 | 1932109675 | $456K |
Showing top 20 of 409 providers billing this code