85045
HCPCS Procedure Code
HCPCS code 85045 is the #1,788 most-billed Medicaid procedure code, with $13.8M in payments across 3.8M claims from 2018–2024. The national median cost per claim is $1.64. Costs vary widely — the 90th percentile is $4.99 per claim, 3.0× the median.
Total Paid
$13.8M
0.00% of all spending
Total Claims
3.8M
Providers
2K
Avg Cost/Claim
$4
National Cost Distribution
How much do providers bill per claim for 85045? Based on 1K providers billing this code nationally.
Median
$1.64
Average
$6.74
Std Dev
$31.02
Max
$592.35
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.58 and $3.10 per claim for this code.
90% bill between $0.10 and $4.99.
Top 1% bill above $152.44.
About This Procedure
HCPCS code 85045 was billed by 2K providers across 3.8M claims, totaling $13.8M in Medicaid payments from 2018–2024. This code was used for 3.3M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$1.64
Providers Billing
1K
National Spending
$13.8M
Avg/Median Ratio
4.11×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 85045
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1992727663 | $1.1M |
| 2 | Renal Care Group Of The Southeast Inc. Pensacola, FL · Clinic/Center End-Stage Renal Disease (ESRD) Treatment | $489K |
| 3 | Children's Health System Of Texas Dallas, TX · General Acute Care Hospital Children | $423K |
| 4 | 1316127921 | $392K |
| 5 | Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children | $357K |
| 6 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $336K |
| 7 | 1578531802 | $333K |
| 8 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $317K |
| 9 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $252K |
| 10 | 1982606992 | $233K |
| 11 | 1134399397 | $219K |
| 12 | 1245720820 | $218K |
| 13 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $197K |
| 14 | 1245208057 | $189K |
| 15 | 1447362280 | $176K |
| 16 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $162K |
| 17 | The Nemours Foundation Wilmington, DE · General Acute Care Hospital Children | $160K |
| 18 | 1932176484 | $157K |
| 19 | 1265400501 | $148K |
| 20 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $138K |
Showing top 20 of 2K providers billing this code