86831
HCPCS Procedure Code
HCPCS code 86831 is the #5,187 most-billed Medicaid procedure code, with $267K in payments across 7K claims from 2018–2024. The national median cost per claim is $25.35. Costs vary widely — the 90th percentile is $63.61 per claim, 2.5× the median.
Total Paid
$267K
0.00% of all spending
Total Claims
7K
Providers
13
Avg Cost/Claim
$37
National Cost Distribution
How much do providers bill per claim for 86831? Based on 12 providers billing this code nationally.
Median
$25.35
Average
$31.05
Std Dev
$22.88
Max
$68.62
Percentile Distribution (Cost per Claim)
50% of providers bill between $12.67 and $46.43 per claim for this code.
90% bill between $7.12 and $63.61.
Top 1% bill above $68.17.
About This Procedure
HCPCS code 86831 was billed by 13 providers across 7K claims, totaling $267K in Medicaid payments from 2018–2024. This code was used for 6K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$25.35
Providers Billing
12
National Spending
$267K
Avg/Median Ratio
1.22×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86831
| # | Provider | Total Paid |
|---|---|---|
| 1 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $146K |
| 2 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $27K |
| 3 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $27K |
| 4 | Sharp Memorial Hospital San Diego, CA · General Acute Care Hospital, Women | $21K |
| 5 | 1164493847 | $21K |
| 6 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $9K |
| 7 | Inova Health Care Services Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder | $8K |
| 8 | Upmc Presbyterian Shadyside Pittsburgh, PA · Clinic/Center | $4K |
| 9 | 1639172372 | $4K |
| 10 | 1568431088 | $354 |
| 11 | North Carolina Baptist Hospital Winston Salem, NC · General Acute Care Hospital | $168 |
| 12 | 1437197985 | $92 |
| 13 | 1154392231 | $0 |
Showing top 13 of 13 providers billing this code