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

#1867 of 11K

86735

HCPCS Procedure Code

HCPCS code 86735 is the #1,867 most-billed Medicaid procedure code, with $12.5M in payments across 2.0M claims from 2018–2024. The national median cost per claim is $8.10.

Total Paid

$12.5M

0.00% of all spending

Total Claims

2.0M

Providers

507

Avg Cost/Claim

$6

National Cost Distribution

How much do providers bill per claim for 86735? Based on 464 providers billing this code nationally.

Median

$8.10

Average

$9.64

Std Dev

$10.13

Max

$140.48

Percentile Distribution (Cost per Claim)

p10
$2.57
p25
$5.13
Median
$8.10
p75
$11.17
p90
$14.70
p95
$21.48
p99
$42.75

50% of providers bill between $5.13 and $11.17 per claim for this code.

90% bill between $2.57 and $14.70.

Top 1% bill above $42.75.

About This Procedure

HCPCS code 86735 was billed by 507 providers across 2.0M claims, totaling $12.5M in Medicaid payments from 2018–2024. This code was used for 1.9M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$8.10

Providers Billing

464

National Spending

$12.5M

Avg/Median Ratio

1.19×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86735

#ProviderTotal Paid
1Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$1.6M
2Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$1.6M
3Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$1.3M
4Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$499K
5Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$437K
6Empire City Laboratories, Inc

Brooklyn, NY · Clinical Medical Laboratory

$436K
7Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$371K
8Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$295K
9Lenco Diagnostic Laboratories,inc.

Brooklyn, NY · Clinical Medical Laboratory

$259K
10Quest Diagnostics Llc Il

Wood Dale, IL · Clinical Medical Laboratory

$244K
11Sunrise Medical Laboratories, Inc.

Hicksville, NY · Clinical Medical Laboratory

$239K
12Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$203K
13Quest Diagnostics Massachusetts Llc

Marlborough, MA · Clinical Medical Laboratory

$200K
14Quest Diagnostics Llc

Marlborough, MA · Clinical Medical Laboratory

$152K
151467586792$151K
16Sherman Abrams Laboratory Inc

Brooklyn, NY · Clinical Medical Laboratory

$144K
17Quest Diagnostics Of Pennsylvania, Inc.

Pittsburgh, PA · Clinical Medical Laboratory

$136K
18Laboratory Corporation Of America

Seattle, WA · Clinical Medical Laboratory

$134K
19Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$124K
20Laboratory Corporation Of America

San Diego, CA · Clinical Medical Laboratory

$110K

Showing top 20 of 507 providers billing this code

Related Procedures