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#6888 of 11K

86638

HCPCS Procedure Code

HCPCS code 86638 is the #6,888 most-billed Medicaid procedure code, with $38K in payments across 3K claims from 2018–2024. The national median cost per claim is $10.50.

Total Paid

$38K

0.00% of all spending

Total Claims

3K

Providers

7

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for 86638? Based on 7 providers billing this code nationally.

Median

$10.50

Average

$11.63

Std Dev

$4.37

Max

$19.39

Percentile Distribution (Cost per Claim)

p10
$7.21
p25
$8.48
Median
$10.50
p75
$13.74
p90
$16.31
p95
$17.85
p99
$19.08

50% of providers bill between $8.48 and $13.74 per claim for this code.

90% bill between $7.21 and $16.31.

Top 1% bill above $19.08.

About This Procedure

HCPCS code 86638 was billed by 7 providers across 3K claims, totaling $38K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$10.50

Providers Billing

7

National Spending

$38K

Avg/Median Ratio

1.11×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86638

#ProviderTotal Paid
1Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$25K
21184861353$6K
3Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$3K
4Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$2K
51124130653$1K
61780620526$371
7Accu Reference Medical Lab, Llc

Linden, NJ · Clinical Medical Laboratory

$263

Showing top 7 of 7 providers billing this code