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#5716 of 11K

86941

HCPCS Procedure Code

HCPCS code 86941 is the #5,716 most-billed Medicaid procedure code, with $149K in payments across 9,897 claims from 2018–2024. The national median cost per claim is $7.26. Costs vary widely — the 90th percentile is $16.10 per claim, 2.2× the median.

Total Paid

$149K

0.00% of all spending

Total Claims

9,897

Providers

6

Avg Cost/Claim

$15

National Cost Distribution

How much do providers bill per claim for 86941? Based on 6 providers billing this code nationally.

Median

$7.26

Average

$9.04

Std Dev

$5.83

Max

$16.19

Percentile Distribution (Cost per Claim)

p10
$3.77
p25
$5.20
Median
$7.26
p75
$14.23
p90
$16.10
p95
$16.14
p99
$16.18

50% of providers bill between $5.20 and $14.23 per claim for this code.

90% bill between $3.77 and $16.10.

Top 1% bill above $16.18.

About This Procedure

HCPCS code 86941 was billed by 6 providers across 9,897 claims, totaling $149K in Medicaid payments from 2018–2024. This code was used for 9,050 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.26

Providers Billing

6

National Spending

$149K

Avg/Median Ratio

1.25×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 86941

#ProviderTotal Paid
1Arrowhead Regional Medical Center

Colton, CA · General Acute Care Hospital

$143K
21982625661$2K
3Brigham & Womens Hospital Inc.

Boston, MA · General Acute Care Hospital

$2K
41558410217$1K
51326061730$712
61881632107$127

Showing top 6 of 6 providers billing this code

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