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#8742 of 11K

86940

HCPCS Procedure Code

HCPCS code 86940 is the #8,742 most-billed Medicaid procedure code, with $1K in payments across 380 claims from 2018–2024. The national median cost per claim is $2.77. Costs vary widely — the 90th percentile is $6.87 per claim, 2.5× the median.

Total Paid

$1K

0.00% of all spending

Total Claims

380

Providers

5

Avg Cost/Claim

$4

National Cost Distribution

How much do providers bill per claim for 86940? Based on 5 providers billing this code nationally.

Median

$2.77

Average

$3.64

Std Dev

$3.34

Max

$9.28

Percentile Distribution (Cost per Claim)

p10
$1.24
p25
$2.52
Median
$2.77
p75
$3.25
p90
$6.87
p95
$8.07
p99
$9.04

50% of providers bill between $2.52 and $3.25 per claim for this code.

90% bill between $1.24 and $6.87.

Top 1% bill above $9.04.

About This Procedure

HCPCS code 86940 was billed by 5 providers across 380 claims, totaling $1K in Medicaid payments from 2018–2024. This code was used for 280 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$2.77

Providers Billing

5

National Spending

$1K

Avg/Median Ratio

1.31×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86940

#ProviderTotal Paid
1Arkansas Childrens Hospital

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

$668
21003878240$318
31780611566$283
41881632107$55
51700848835$29

Showing top 5 of 5 providers billing this code