86609
HCPCS Procedure Code
HCPCS code 86609 is the #6,393 most-billed Medicaid procedure code, with $69K in payments across 9K claims from 2018–2024. The national median cost per claim is $6.88. Costs vary widely — the 90th percentile is $20.32 per claim, 3.0× the median.
Total Paid
$69K
0.00% of all spending
Total Claims
9K
Providers
25
Avg Cost/Claim
$8
National Cost Distribution
How much do providers bill per claim for 86609? Based on 24 providers billing this code nationally.
Median
$6.88
Average
$9.39
Std Dev
$9.75
Max
$42.16
Percentile Distribution (Cost per Claim)
50% of providers bill between $4.15 and $9.21 per claim for this code.
90% bill between $2.05 and $20.32.
Top 1% bill above $39.56.
About This Procedure
HCPCS code 86609 was billed by 25 providers across 9K claims, totaling $69K in Medicaid payments from 2018–2024. This code was used for 8K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$6.88
Providers Billing
24
National Spending
$69K
Avg/Median Ratio
1.36×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86609
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $22K |
| 2 | 1700886322 | $14K |
| 3 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $11K |
| 4 | Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory | $4K |
| 5 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $3K |
| 6 | Accurate Diagnostics Labs, Inc. South Plainfield, NJ · Clinical Medical Laboratory | $3K |
| 7 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $3K |
| 8 | 1891873303 | $1K |
| 9 | Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory | $1K |
| 10 | 1235234402 | $1K |
| 11 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $1K |
| 12 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $1K |
| 13 | 1972549855 | $632 |
| 14 | 1780620526 | $538 |
| 15 | 1235131442 | $490 |
| 16 | 1942226006 | $463 |
| 17 | 1780059717 | $429 |
| 18 | 1124130653 | $232 |
| 19 | Quest Diagnostics Incorporated Las Vegas, NV · Clinical Medical Laboratory | $185 |
| 20 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $94 |
Showing top 20 of 25 providers billing this code