Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1452 of 11K

85041

HCPCS Procedure Code

HCPCS code 85041 is the #1,452 most-billed Medicaid procedure code, with $22.8M in payments across 1.8M claims from 2018–2024. The national median cost per claim is $0.76. Costs vary widely — the 90th percentile is $118.55 per claim, 156.0× the median.

Total Paid

$22.8M

0.00% of all spending

Total Claims

1.8M

Providers

2K

Avg Cost/Claim

$13

National Cost Distribution

How much do providers bill per claim for 85041? Based on 909 providers billing this code nationally.

Median

$0.76

Average

$26.23

Std Dev

$53.30

Max

$269.00

Percentile Distribution (Cost per Claim)

p10
$0.01
p25
$0.06
Median
$0.76
p75
$7.27
p90
$118.55
p95
$149.57
p99
$206.90

50% of providers bill between $0.06 and $7.27 per claim for this code.

90% bill between $0.01 and $118.55.

Top 1% bill above $206.90.

About This Procedure

HCPCS code 85041 was billed by 2K providers across 1.8M claims, totaling $22.8M in Medicaid payments from 2018–2024. This code was used for 1.5M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.76

Providers Billing

909

National Spending

$22.8M

Avg/Median Ratio

34.51×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 85041

#ProviderTotal Paid
11003883125$568K
21255308722$389K
31154399491$366K
41841268596$358K
51942278270$337K
61861749194$334K
71285690248$329K
81154799948$323K
91942567839$315K
101528036050$293K
111538137799$288K
121275771891$286K
131316915077$258K
141245208057$249K
151356319859$248K
161043277015$242K
171639147259$239K
181417258245$239K
191104217918$238K
201255579629$238K

Showing top 20 of 2K providers billing this code