86611
HCPCS Procedure Code
HCPCS code 86611 is the #5,173 most-billed Medicaid procedure code, with $269K in payments across 34K claims from 2018–2024. The national median cost per claim is $8.69. Costs vary widely — the 90th percentile is $21.87 per claim, 2.5× the median.
Total Paid
$269K
0.00% of all spending
Total Claims
34K
Providers
42
Avg Cost/Claim
$8
National Cost Distribution
How much do providers bill per claim for 86611? Based on 42 providers billing this code nationally.
Median
$8.69
Average
$10.17
Std Dev
$7.79
Max
$35.22
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.16 and $13.36 per claim for this code.
90% bill between $0.91 and $21.87.
Top 1% bill above $31.01.
About This Procedure
HCPCS code 86611 was billed by 42 providers across 34K claims, totaling $269K in Medicaid payments from 2018–2024. This code was used for 26K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$8.69
Providers Billing
42
National Spending
$269K
Avg/Median Ratio
1.17×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86611
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1447296272 | $49K |
| 2 | 1750373908 | $40K |
| 3 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $33K |
| 4 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $23K |
| 5 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $18K |
| 6 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $16K |
| 7 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $16K |
| 8 | Sunrise Medical Laboratories, Inc. Hicksville, NY · Clinical Medical Laboratory | $9K |
| 9 | Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory | $9K |
| 10 | 1376548271 | $8K |
| 11 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $6K |
| 12 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $6K |
| 13 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $5K |
| 14 | Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory | $4K |
| 15 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $3K |
| 16 | Permanente Medical Group, Inc. Richmond, CA · Clinical Medical Laboratory | $3K |
| 17 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $3K |
| 18 | 1073587937 | $2K |
| 19 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $2K |
| 20 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $2K |
Showing top 20 of 42 providers billing this code