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#2611 of 11K

86922

HCPCS Procedure Code

HCPCS code 86922 is the #2,611 most-billed Medicaid procedure code, with $4.6M in payments across 118K claims from 2018–2024. The national median cost per claim is $20.85. Costs vary widely — the 90th percentile is $84.26 per claim, 4.0× the median.

Total Paid

$4.6M

0.00% of all spending

Total Claims

118K

Providers

184

Avg Cost/Claim

$39

National Cost Distribution

How much do providers bill per claim for 86922? Based on 163 providers billing this code nationally.

Median

$20.85

Average

$38.76

Std Dev

$70.70

Max

$700.64

Percentile Distribution (Cost per Claim)

p10
$3.36
p25
$9.11
Median
$20.85
p75
$40.25
p90
$84.26
p95
$106.91
p99
$321.66

50% of providers bill between $9.11 and $40.25 per claim for this code.

90% bill between $3.36 and $84.26.

Top 1% bill above $321.66.

About This Procedure

HCPCS code 86922 was billed by 184 providers across 118K claims, totaling $4.6M in Medicaid payments from 2018–2024. This code was used for 77K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$20.85

Providers Billing

163

National Spending

$4.6M

Avg/Median Ratio

1.86×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 86922

#ProviderTotal Paid
1State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$1.0M
2Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$259K
3Children's Hospital & Research Center At Oakland

Oakland, CA · General Acute Care Hospital

$240K
4Children's Hospital

Washington, DC · General Acute Care Hospital Children

$214K
5Childrens Hospital Of The Kings Daughters Inc

Norfolk, VA · Social Worker, Clinical

$153K
6Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$147K
71205935012$145K
8Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$126K
9Arkansas Childrens Hospital

Little Rock, AR · Clinic/Center, Critical Access Hospital

$115K
101366459570$114K
11Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$106K
121710909585$105K
13Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$102K
141689761942$82K
15Florida Clinical Practice Association Inc

Gainesville, FL · Surgery

$81K
16Newark Beth Israel Medical Center Inc

Newark, NJ · General Acute Care Hospital

$80K
17Regents Of The University Of California

Sacramento, CA · General Acute Care Hospital

$75K
181225041809$62K
191043218944$61K
20Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$61K

Showing top 20 of 184 providers billing this code