86694
HCPCS Procedure Code
HCPCS code 86694 is the #3,104 most-billed Medicaid procedure code, with $2.5M in payments across 309K claims from 2018–2024. The national median cost per claim is $10.62.
Total Paid
$2.5M
0.00% of all spending
Total Claims
309K
Providers
259
Avg Cost/Claim
$8
National Cost Distribution
How much do providers bill per claim for 86694? Based on 249 providers billing this code nationally.
Median
$10.62
Average
$11.67
Std Dev
$8.09
Max
$80.34
Percentile Distribution (Cost per Claim)
50% of providers bill between $7.37 and $13.95 per claim for this code.
90% bill between $2.94 and $18.89.
Top 1% bill above $36.83.
About This Procedure
HCPCS code 86694 was billed by 259 providers across 309K claims, totaling $2.5M in Medicaid payments from 2018–2024. This code was used for 291K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$10.62
Providers Billing
249
National Spending
$2.5M
Avg/Median Ratio
1.10×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86694
| # | Provider | Total Paid |
|---|---|---|
| 1 | Sunrise Medical Laboratories, Inc. Hicksville, NY · Clinical Medical Laboratory | $209K |
| 2 | 1235186800 | $158K |
| 3 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $152K |
| 4 | Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory | $150K |
| 5 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $137K |
| 6 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $72K |
| 7 | Tricore Reference Laboratories Albuquerque, NM · Clinical Medical Laboratory | $68K |
| 8 | 1548208440 | $67K |
| 9 | Empire City Laboratories, Inc Brooklyn, NY · Clinical Medical Laboratory | $65K |
| 10 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $50K |
| 11 | 1376548271 | $48K |
| 12 | 1649767948 | $47K |
| 13 | Accurate Diagnostics Labs, Inc. South Plainfield, NJ · Clinical Medical Laboratory | $41K |
| 14 | Tricore Inc. Albuquerque, NM · Clinical Medical Laboratory | $40K |
| 15 | 1457341851 | $38K |
| 16 | 1134195357 | $34K |
| 17 | 1861404121 | $33K |
| 18 | 1346285988 | $31K |
| 19 | 1245275106 | $30K |
| 20 | Nyu Langone Hospitals New York, NY · Clinic/Center, Oncology | $30K |
Showing top 20 of 259 providers billing this code