Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1233 of 11K

86703

HCPCS Procedure Code

HCPCS code 86703 is the #1,233 most-billed Medicaid procedure code, with $32.2M in payments across 3.1M claims from 2018–2024. The national median cost per claim is $10.37.

Total Paid

$32.2M

0.00% of all spending

Total Claims

3.1M

Providers

2K

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for 86703? Based on 2K providers billing this code nationally.

Median

$10.37

Average

$10.77

Std Dev

$15.79

Max

$443.10

Percentile Distribution (Cost per Claim)

p10
$1.10
p25
$4.74
Median
$10.37
p75
$12.64
p90
$16.83
p95
$21.59
p99
$49.55

50% of providers bill between $4.74 and $12.64 per claim for this code.

90% bill between $1.10 and $16.83.

Top 1% bill above $49.55.

About This Procedure

HCPCS code 86703 was billed by 2K providers across 3.1M claims, totaling $32.2M in Medicaid payments from 2018–2024. This code was used for 2.9M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$10.37

Providers Billing

2K

National Spending

$32.2M

Avg/Median Ratio

1.04×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86703

#ProviderTotal Paid
1Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$1.3M
2Alameda Health System

Oakland, CA · General Acute Care Hospital

$991K
3Bronxcare Health System

Bronx, NY · General Acute Care Hospital

$812K
4Yukon-kuskokwim Health Corporation

Bethel, AK · General Acute Care Hospital Rural

$799K
51417959701$748K
6Lexington Health Inc

West Columbia, SC · General Acute Care Hospital

$700K
71710916945$590K
8Doctors Hospital At Renaissance, Ltd

Edinburg, TX · Clinic/Center, Ambulatory Surgical

$568K
91144202003$548K
10New York City Health And Hospitals Corporation

Bronx, NY · Internal Medicine

$522K
111548225428$413K
12Tarrant County Hospital District

Fort Worth, TX · Clinic/Center, Ambulatory Family Planning Facility

$399K
131942221098$387K
14Nyu Langone Hospitals

Brooklyn, NY · General Acute Care Hospital

$381K
15Lenco Diagnostic Laboratories,inc.

Brooklyn, NY · Clinical Medical Laboratory

$371K
16New York City Health And Hospitals Corporation

Bronx, NY · Internal Medicine

$362K
17New York City Health And Hospitals Corporation

Brooklyn, NY · Internal Medicine

$312K
181356406136$301K
191033124961$277K
20County Of Ventura

Ventura, CA · Clinic/Center, Emergency Care

$273K

Showing top 20 of 2K providers billing this code