86923
HCPCS Procedure Code
HCPCS code 86923 is the #1,789 most-billed Medicaid procedure code, with $13.8M in payments across 561K claims from 2018–2024. The national median cost per claim is $14.07. Costs vary widely — the 90th percentile is $79.43 per claim, 5.6× the median.
Total Paid
$13.8M
0.00% of all spending
Total Claims
561K
Providers
574
Avg Cost/Claim
$25
National Cost Distribution
How much do providers bill per claim for 86923? Based on 503 providers billing this code nationally.
Median
$14.07
Average
$33.13
Std Dev
$75.36
Max
$1,324.97
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.04 and $35.49 per claim for this code.
90% bill between $1.22 and $79.43.
Top 1% bill above $203.58.
About This Procedure
HCPCS code 86923 was billed by 574 providers across 561K claims, totaling $13.8M in Medicaid payments from 2018–2024. This code was used for 380K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$14.07
Providers Billing
503
National Spending
$13.8M
Avg/Median Ratio
2.35×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 86923
| # | Provider | Total Paid |
|---|---|---|
| 1 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $1.1M |
| 2 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $383K |
| 3 | Children's Hospital & Research Center At Oakland Oakland, CA · General Acute Care Hospital | $382K |
| 4 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $360K |
| 5 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $304K |
| 6 | 1871522680 | $299K |
| 7 | Children's Hospital Corporation Boston, MA · Clinic/Center | $291K |
| 8 | Carolinas Medical Center Charlotte, NC · General Acute Care Hospital | $245K |
| 9 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $228K |
| 10 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $208K |
| 11 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $204K |
| 12 | Dallas County Hospital District Dallas, TX · Clinic/Center, Ambulatory Surgical | $204K |
| 13 | Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine | $202K |
| 14 | Kaiser Foundation Hospitals Downey, CA · General Acute Care Hospital | $189K |
| 15 | 1821143777 | $180K |
| 16 | Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children | $177K |
| 17 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $169K |
| 18 | 1356496772 | $164K |
| 19 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $158K |
| 20 | 1225041809 | $156K |
Showing top 20 of 574 providers billing this code