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#4540 of 11K

86774

HCPCS Procedure Code

HCPCS code 86774 is the #4,540 most-billed Medicaid procedure code, with $525K in payments across 69K claims from 2018–2024. The national median cost per claim is $7.94.

Total Paid

$525K

0.00% of all spending

Total Claims

69K

Providers

61

Avg Cost/Claim

$8

National Cost Distribution

How much do providers bill per claim for 86774? Based on 57 providers billing this code nationally.

Median

$7.94

Average

$8.82

Std Dev

$7.20

Max

$45.02

Percentile Distribution (Cost per Claim)

p10
$2.16
p25
$4.37
Median
$7.94
p75
$10.83
p90
$15.01
p95
$19.03
p99
$35.15

50% of providers bill between $4.37 and $10.83 per claim for this code.

90% bill between $2.16 and $15.01.

Top 1% bill above $35.15.

About This Procedure

HCPCS code 86774 was billed by 61 providers across 69K claims, totaling $525K in Medicaid payments from 2018–2024. This code was used for 67K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.94

Providers Billing

57

National Spending

$525K

Avg/Median Ratio

1.11×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86774

#ProviderTotal Paid
1Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$128K
2Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$85K
3Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$43K
4Children's Hospital Corporation

Boston, MA · Clinic/Center

$29K
51447296272$28K
6Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$26K
7Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$22K
8Childrens Hospital Of Philadelphia

Philadelphia, PA · General Acute Care Hospital Children

$16K
9Quest Diagnostics Llc Il

Wood Dale, IL · Clinical Medical Laboratory

$14K
10Quest Diagnostics Clinical Laboratories Inc

Irving, TX · Clinical Medical Laboratory

$14K
11Labone Of Ohio Inc

Cincinnati, OH · Clinical Medical Laboratory

$13K
12Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$12K
13Arkansas Childrens Hospital

Little Rock, AR · Clinic/Center, Critical Access Hospital

$11K
141922008150$10K
15Quest Diagnostics Clinical Laboratories Inc

Tucker, GA · Clinical Medical Laboratory

$9K
16Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$8K
17Sherman Abrams Laboratory Inc

Brooklyn, NY · Clinical Medical Laboratory

$5K
181124130653$5K
19Quest Diagnostics Of Pennsylvania, Inc.

Pittsburgh, PA · Clinical Medical Laboratory

$5K
201780620526$4K

Showing top 20 of 61 providers billing this code