86921
HCPCS Procedure Code
HCPCS code 86921 is the #6,289 most-billed Medicaid procedure code, with $77K in payments across 12K claims from 2018–2024. The national median cost per claim is $7.48. Costs vary widely — the 90th percentile is $16.95 per claim, 2.3× the median.
Total Paid
$77K
0.00% of all spending
Total Claims
12K
Providers
21
Avg Cost/Claim
$7
National Cost Distribution
How much do providers bill per claim for 86921? Based on 15 providers billing this code nationally.
Median
$7.48
Average
$10.12
Std Dev
$9.73
Max
$40.32
Percentile Distribution (Cost per Claim)
50% of providers bill between $4.20 and $12.77 per claim for this code.
90% bill between $2.69 and $16.95.
Top 1% bill above $37.35.
About This Procedure
HCPCS code 86921 was billed by 21 providers across 12K claims, totaling $77K in Medicaid payments from 2018–2024. This code was used for 7,393 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$7.48
Providers Billing
15
National Spending
$77K
Avg/Median Ratio
1.35×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86921
| # | Provider | Total Paid |
|---|---|---|
| 1 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $15K |
| 2 | 1437119310 | $14K |
| 3 | 1295728673 | $10K |
| 4 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $7K |
| 5 | Hmh Hospitals Corporation Hackensack, NJ · Ambulance | $7K |
| 6 | 1457321036 | $7K |
| 7 | 1144277633 | $5K |
| 8 | 1053334755 | $5K |
| 9 | 1659387975 | $4K |
| 10 | 1710917836 | $1K |
| 11 | The Nemours Foundation Wilmington, DE · General Acute Care Hospital Children | $897 |
| 12 | 1801851795 | $807 |
| 13 | 1700878238 | $158 |
| 14 | 1427019173 | $147 |
| 15 | 1992789721 | $128 |
| 16 | 1588656946 | $0 |
| 17 | 1801858964 | $0 |
| 18 | 1154373843 | $0 |
| 19 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $0 |
| 20 | 1487868097 | $0 |
Showing top 20 of 21 providers billing this code