86900
HCPCS Procedure Code
HCPCS code 86900 is the #647 most-billed Medicaid procedure code, with $115.7M in payments across 16.2M claims from 2018–2024. The national median cost per claim is $2.55. Costs vary widely — the 90th percentile is $22.46 per claim, 8.8× the median.
Total Paid
$115.7M
0.01% of all spending
Total Claims
16.2M
Providers
4K
Avg Cost/Claim
$7
National Cost Distribution
How much do providers bill per claim for 86900? Based on 4K providers billing this code nationally.
Median
$2.55
Average
$9.34
Std Dev
$36.65
Max
$1,768.87
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.30 and $7.21 per claim for this code.
90% bill between $0.33 and $22.46.
Top 1% bill above $90.06.
About This Procedure
HCPCS code 86900 was billed by 4K providers across 16.2M claims, totaling $115.7M in Medicaid payments from 2018–2024. This code was used for 13.9M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$2.55
Providers Billing
4K
National Spending
$115.7M
Avg/Median Ratio
3.66×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 86900
| # | Provider | Total Paid |
|---|---|---|
| 1 | Alaska Native Tribal Health Consortium Anchorage, AK · General Acute Care Hospital | $3.9M |
| 2 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $2.5M |
| 3 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $1.9M |
| 4 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $1.5M |
| 5 | Lexington Health Inc West Columbia, SC · General Acute Care Hospital | $1.2M |
| 6 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $1.1M |
| 7 | Women & Infants Hospital Of Rhode Island Providence, RI · Clinic/Center, Ambulatory Family Planning Facility | $1.1M |
| 8 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $1.1M |
| 9 | Adventist Health System-sunbelt, Inc Orlando, FL · Ambulance, Land Transport | $1.0M |
| 10 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $915K |
| 11 | 1356496772 | $886K |
| 12 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $866K |
| 13 | 1649299827 | $847K |
| 14 | Mount Sinai Hospital New York, NY · Ambulance | $831K |
| 15 | State Of Connecticut Farmington, CT · Counselor, Professional | $805K |
| 16 | 1033107743 | $751K |
| 17 | 1356366314 | $737K |
| 18 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $734K |
| 19 | 1225041809 | $657K |
| 20 | Henry Ford Health System Detroit, MI · General Acute Care Hospital | $651K |
Showing top 20 of 4K providers billing this code