86704
HCPCS Procedure Code
HCPCS code 86704 is the #1,147 most-billed Medicaid procedure code, with $37.1M in payments across 5.8M claims from 2018–2024. The national median cost per claim is $7.48. Costs vary widely — the 90th percentile is $16.66 per claim, 2.2× the median.
Total Paid
$37.1M
0.00% of all spending
Total Claims
5.8M
Providers
2K
Avg Cost/Claim
$6
National Cost Distribution
How much do providers bill per claim for 86704? Based on 1K providers billing this code nationally.
Median
$7.48
Average
$13.59
Std Dev
$35.07
Max
$708.94
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.10 and $11.06 per claim for this code.
90% bill between $0.55 and $16.66.
Top 1% bill above $180.86.
About This Procedure
HCPCS code 86704 was billed by 2K providers across 5.8M claims, totaling $37.1M in Medicaid payments from 2018–2024. This code was used for 5.5M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$7.48
Providers Billing
1K
National Spending
$37.1M
Avg/Median Ratio
1.82×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 86704
| # | Provider | Total Paid |
|---|---|---|
| 1 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $2.9M |
| 2 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $1.6M |
| 3 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $1.6M |
| 4 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $1.5M |
| 5 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $1.3M |
| 6 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $1.2M |
| 7 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $859K |
| 8 | Laboratory Corporation Of America Seattle, WA · Clinical Medical Laboratory | $698K |
| 9 | 1144202003 | $690K |
| 10 | Unilab Corporation Sacramento, CA · Clinical Medical Laboratory | $582K |
| 11 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $523K |
| 12 | Empire City Laboratories, Inc Brooklyn, NY · Clinical Medical Laboratory | $503K |
| 13 | Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory | $488K |
| 14 | Quest Diagnostics Llc Marlborough, MA · Clinical Medical Laboratory | $443K |
| 15 | Quest Diagnostics Massachusetts Llc Marlborough, MA · Clinical Medical Laboratory | $407K |
| 16 | Lenco Diagnostic Laboratories,inc. Brooklyn, NY · Clinical Medical Laboratory | $368K |
| 17 | Labone Of Ohio Inc Cincinnati, OH · Clinical Medical Laboratory | $366K |
| 18 | 1316983158 | $344K |
| 19 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $327K |
| 20 | Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory | $319K |
Showing top 20 of 2K providers billing this code