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#3945 of 11K

L1686

HCPCS Procedure Code

HCPCS code L1686 is the #3,945 most-billed Medicaid procedure code, with $992K in payments across 2K claims from 2018–2024. The national median cost per claim is $189.37. Costs vary widely — the 90th percentile is $673.65 per claim, 3.6× the median.

Total Paid

$992K

0.00% of all spending

Total Claims

2K

Providers

11

Avg Cost/Claim

$536

National Cost Distribution

How much do providers bill per claim for L1686? Based on 10 providers billing this code nationally.

Median

$189.37

Average

$346.26

Std Dev

$374.98

Max

$1,198.38

Percentile Distribution (Cost per Claim)

p10
$54.95
p25
$68.13
Median
$189.37
p75
$551.18
p90
$673.65
p95
$936.02
p99
$1,145.91

50% of providers bill between $68.13 and $551.18 per claim for this code.

90% bill between $54.95 and $673.65.

Top 1% bill above $1,145.91.

About This Procedure

HCPCS code L1686 was billed by 11 providers across 2K claims, totaling $992K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$189.37

Providers Billing

10

National Spending

$992K

Avg/Median Ratio

1.83×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for L1686

#ProviderTotal Paid
11093819419$446K
2Djo, Llc

Carlsbad, CA · Prosthetic/Orthotic Supplier

$337K
31942238514$112K
41336552140$79K
51356372809$7K
61912540022$4K
71659997393$3K
81982257002$2K
91255822615$1K
101902435803$936
111457973240$0

Showing top 11 of 11 providers billing this code

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