85130
HCPCS Procedure Code
HCPCS code 85130 is the #6,058 most-billed Medicaid procedure code, with $100K in payments across 14K claims from 2018–2024. The national median cost per claim is $5.84.
Total Paid
$100K
0.00% of all spending
Total Claims
14K
Providers
16
Avg Cost/Claim
$7
National Cost Distribution
How much do providers bill per claim for 85130? Based on 16 providers billing this code nationally.
Median
$5.84
Average
$5.22
Std Dev
$4.00
Max
$11.05
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.23 and $8.16 per claim for this code.
90% bill between $0.16 and $10.64.
Top 1% bill above $11.00.
About This Procedure
HCPCS code 85130 was billed by 16 providers across 14K claims, totaling $100K in Medicaid payments from 2018–2024. This code was used for 3,859 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$5.84
Providers Billing
16
National Spending
$100K
Avg/Median Ratio
0.89×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 85130
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1922008150 | $76K |
| 2 | 1811121726 | $9K |
| 3 | 1114902814 | $6K |
| 4 | 1518917350 | $5K |
| 5 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $1K |
| 6 | Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine | $740 |
| 7 | 1437125580 | $723 |
| 8 | Tricore Reference Laboratories Albuquerque, NM · Clinical Medical Laboratory | $268 |
| 9 | Sage River Counseling Seattle, WA · Counselor Mental Health | $236 |
| 10 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $79 |
| 11 | 1689677148 | $76 |
| 12 | 1316241102 | $51 |
| 13 | 1255313664 | $30 |
| 14 | Orlando Health Inc. Orlando, FL · General Acute Care Hospital | $20 |
| 15 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $16 |
| 16 | University Of Washington Seattle, WA · Clinic/Center, Dental | $8 |
Showing top 16 of 16 providers billing this code