86790
HCPCS Procedure Code
HCPCS code 86790 is the #4,214 most-billed Medicaid procedure code, with $752K in payments across 74K claims from 2018–2024. The national median cost per claim is $9.15.
Total Paid
$752K
0.00% of all spending
Total Claims
74K
Providers
140
Avg Cost/Claim
$10
National Cost Distribution
How much do providers bill per claim for 86790? Based on 134 providers billing this code nationally.
Median
$9.15
Average
$12.64
Std Dev
$25.19
Max
$275.02
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.35 and $12.57 per claim for this code.
90% bill between $2.86 and $16.77.
Top 1% bill above $83.54.
About This Procedure
HCPCS code 86790 was billed by 140 providers across 74K claims, totaling $752K in Medicaid payments from 2018–2024. This code was used for 66K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$9.15
Providers Billing
134
National Spending
$752K
Avg/Median Ratio
1.38×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86790
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1326046467 | $63K |
| 2 | Nyu Langone Hospitals New York, NY · Clinic/Center, Oncology | $55K |
| 3 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $47K |
| 4 | Trustees Of The University Of Pennsylvania Philadelphia, PA · Community/Behavioral Health | $37K |
| 5 | University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital | $30K |
| 6 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $30K |
| 7 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $29K |
| 8 | Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital | $23K |
| 9 | 1619980430 | $22K |
| 10 | 1700913118 | $21K |
| 11 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $20K |
| 12 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $20K |
| 13 | 1750373908 | $19K |
| 14 | University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program | $18K |
| 15 | 1114902814 | $17K |
| 16 | 1184606600 | $16K |
| 17 | 1821101403 | $15K |
| 18 | 1639173099 | $14K |
| 19 | Mako Medical Laboratories, Llc Raleigh, NC · Clinical Medical Laboratory | $13K |
| 20 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $13K |
Showing top 20 of 140 providers billing this code