85046
HCPCS Procedure Code
HCPCS code 85046 is the #2,648 most-billed Medicaid procedure code, with $4.4M in payments across 929K claims from 2018–2024. The national median cost per claim is $2.47. Costs vary widely — the 90th percentile is $7.90 per claim, 3.2× the median.
Total Paid
$4.4M
0.00% of all spending
Total Claims
929K
Providers
897
Avg Cost/Claim
$5
National Cost Distribution
How much do providers bill per claim for 85046? Based on 631 providers billing this code nationally.
Median
$2.47
Average
$9.39
Std Dev
$29.53
Max
$255.02
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.71 and $4.92 per claim for this code.
90% bill between $0.10 and $7.90.
Top 1% bill above $164.37.
About This Procedure
HCPCS code 85046 was billed by 897 providers across 929K claims, totaling $4.4M in Medicaid payments from 2018–2024. This code was used for 753K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$2.47
Providers Billing
631
National Spending
$4.4M
Avg/Median Ratio
3.80×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 85046
| # | Provider | Total Paid |
|---|---|---|
| 1 | Texas Children's Hospital Houston, TX · General Acute Care Hospital Children | $444K |
| 2 | The Children's Mercy Hospital Kansas City, MO · General Acute Care Hospital Children | $358K |
| 3 | 1508935891 | $213K |
| 4 | 1003826090 | $174K |
| 5 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $167K |
| 6 | 1558792960 | $160K |
| 7 | Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital | $137K |
| 8 | 1235148297 | $120K |
| 9 | 1396321022 | $98K |
| 10 | 1205935012 | $79K |
| 11 | 1801908645 | $76K |
| 12 | 1578963211 | $72K |
| 13 | 1124024922 | $71K |
| 14 | Driscoll Childrens Hospital Corpus Christi, TX · Speech-Language Pathologist, | $70K |
| 15 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $69K |
| 16 | Curators Of The University Of Missouri Columbia, MO · General Acute Care Hospital | $59K |
| 17 | Vhs Childrens Hospital Of Michigan Inc Detroit, MI · Clinic/Center, Ambulatory Surgical | $52K |
| 18 | 1912978834 | $51K |
| 19 | 1558473306 | $51K |
| 20 | 1336245828 | $49K |
Showing top 20 of 897 providers billing this code