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#1141 of 11K

86696

HCPCS Procedure Code

HCPCS code 86696 is the #1,141 most-billed Medicaid procedure code, with $37.8M in payments across 3.6M claims from 2018–2024. The national median cost per claim is $13.89.

Total Paid

$37.8M

0.00% of all spending

Total Claims

3.6M

Providers

868

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for 86696? Based on 806 providers billing this code nationally.

Median

$13.89

Average

$14.44

Std Dev

$10.32

Max

$131.39

Percentile Distribution (Cost per Claim)

p10
$4.20
p25
$9.25
Median
$13.89
p75
$17.98
p90
$21.78
p95
$25.85
p99
$48.44

50% of providers bill between $9.25 and $17.98 per claim for this code.

90% bill between $4.20 and $21.78.

Top 1% bill above $48.44.

About This Procedure

HCPCS code 86696 was billed by 868 providers across 3.6M claims, totaling $37.8M in Medicaid payments from 2018–2024. This code was used for 3.4M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.89

Providers Billing

806

National Spending

$37.8M

Avg/Median Ratio

1.04×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86696

#ProviderTotal Paid
1Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$3.3M
2Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$2.1M
3Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$2.0M
4Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$1.7M
5Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$1.5M
6Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$1.3M
7Laboratory Corporation Of America Holdings

Birmingham, AL · Clinical Medical Laboratory

$1.3M
8Quest Diagnostics Llc Il

Wood Dale, IL · Clinical Medical Laboratory

$1.0M
9Quest Diagnostics Clinical Laboratories Inc

Irving, TX · Clinical Medical Laboratory

$1.0M
10Clinical Pathology Laboratories, Inc.

Austin, TX · Clinical Medical Laboratory

$825K
11Quest Diagnostics Clinical Laboratories Inc

Tucker, GA · Clinical Medical Laboratory

$742K
12Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$666K
13Labone Llc

Lenexa, KS · Clinical Medical Laboratory

$645K
14Empire City Laboratories, Inc

Brooklyn, NY · Clinical Medical Laboratory

$544K
15Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$538K
161235186800$533K
17Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$519K
18Sunrise Medical Laboratories, Inc.

Hicksville, NY · Clinical Medical Laboratory

$503K
19Lenco Diagnostic Laboratories,inc.

Brooklyn, NY · Clinical Medical Laboratory

$497K
20Accu Reference Medical Lab, Llc

Linden, NJ · Clinical Medical Laboratory

$473K

Showing top 20 of 868 providers billing this code