86807
HCPCS Procedure Code
HCPCS code 86807 is the #5,825 most-billed Medicaid procedure code, with $132K in payments across 5K claims from 2018–2024. The national median cost per claim is $32.97. Costs vary widely — the 90th percentile is $76.57 per claim, 2.3× the median.
Total Paid
$132K
0.00% of all spending
Total Claims
5K
Providers
9
Avg Cost/Claim
$26
National Cost Distribution
How much do providers bill per claim for 86807? Based on 9 providers billing this code nationally.
Median
$32.97
Average
$42.22
Std Dev
$44.03
Max
$147.38
Percentile Distribution (Cost per Claim)
50% of providers bill between $9.68 and $50.09 per claim for this code.
90% bill between $9.15 and $76.57.
Top 1% bill above $140.30.
About This Procedure
HCPCS code 86807 was billed by 9 providers across 5K claims, totaling $132K in Medicaid payments from 2018–2024. This code was used for 4K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$32.97
Providers Billing
9
National Spending
$132K
Avg/Median Ratio
1.28×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86807
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1144266024 | $57K |
| 2 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $33K |
| 3 | 1952546616 | $31K |
| 4 | Texas Children's Hospital Houston, TX · General Acute Care Hospital Children | $5K |
| 5 | 1235196510 | $4K |
| 6 | University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital | $824 |
| 7 | 1306846753 | $809 |
| 8 | 1801851258 | $455 |
| 9 | University Of Colorado Hospital Authority Aurora, CO · General Acute Care Hospital | $115 |
Showing top 9 of 9 providers billing this code