86709
HCPCS Procedure Code
HCPCS code 86709 is the #2,230 most-billed Medicaid procedure code, with $7.6M in payments across 1.4M claims from 2018–2024. The national median cost per claim is $6.39.
Total Paid
$7.6M
0.00% of all spending
Total Claims
1.4M
Providers
603
Avg Cost/Claim
$6
National Cost Distribution
How much do providers bill per claim for 86709? Based on 556 providers billing this code nationally.
Median
$6.39
Average
$7.39
Std Dev
$6.88
Max
$63.59
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.35 and $9.28 per claim for this code.
90% bill between $1.10 and $12.69.
Top 1% bill above $37.06.
About This Procedure
HCPCS code 86709 was billed by 603 providers across 1.4M claims, totaling $7.6M in Medicaid payments from 2018–2024. This code was used for 1.3M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$6.39
Providers Billing
556
National Spending
$7.6M
Avg/Median Ratio
1.16×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86709
| # | Provider | Total Paid |
|---|---|---|
| 1 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $1.7M |
| 2 | Empire City Laboratories, Inc Brooklyn, NY · Clinical Medical Laboratory | $426K |
| 3 | Quest Diagnostics Llc Marlborough, MA · Clinical Medical Laboratory | $416K |
| 4 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $315K |
| 5 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $307K |
| 6 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $252K |
| 7 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $239K |
| 8 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $212K |
| 9 | Laboratory Corporation Of America Seattle, WA · Clinical Medical Laboratory | $139K |
| 10 | 1881841120 | $113K |
| 11 | Sunrise Medical Laboratories, Inc. Hicksville, NY · Clinical Medical Laboratory | $99K |
| 12 | 1861404121 | $87K |
| 13 | 1548208440 | $87K |
| 14 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $85K |
| 15 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $80K |
| 16 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $80K |
| 17 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $79K |
| 18 | Bluewater Toxicology Llc Mt Washington, KY · Clinical Medical Laboratory | $77K |
| 19 | Lenco Diagnostic Laboratories,inc. Brooklyn, NY · Clinical Medical Laboratory | $74K |
| 20 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $72K |
Showing top 20 of 603 providers billing this code