85240
HCPCS Procedure Code
HCPCS code 85240 is the #3,081 most-billed Medicaid procedure code, with $2.6M in payments across 256K claims from 2018–2024. The national median cost per claim is $11.38. Costs vary widely — the 90th percentile is $22.78 per claim, 2.0× the median.
Total Paid
$2.6M
0.00% of all spending
Total Claims
256K
Providers
223
Avg Cost/Claim
$10
National Cost Distribution
How much do providers bill per claim for 85240? Based on 219 providers billing this code nationally.
Median
$11.38
Average
$14.81
Std Dev
$22.10
Max
$270.40
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.68 and $16.60 per claim for this code.
90% bill between $3.81 and $22.78.
Top 1% bill above $90.64.
About This Procedure
HCPCS code 85240 was billed by 223 providers across 256K claims, totaling $2.6M in Medicaid payments from 2018–2024. This code was used for 240K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$11.38
Providers Billing
219
National Spending
$2.6M
Avg/Median Ratio
1.30×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 85240
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $306K |
| 2 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $103K |
| 3 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $96K |
| 4 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $75K |
| 5 | 1447296272 | $75K |
| 6 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $67K |
| 7 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $64K |
| 8 | 1700949336 | $63K |
| 9 | Laboratory Corporation Of America Phoenix, AZ · Clinical Medical Laboratory | $53K |
| 10 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $53K |
| 11 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $50K |
| 12 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $47K |
| 13 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $43K |
| 14 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $42K |
| 15 | 1780620526 | $40K |
| 16 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $39K |
| 17 | 1629109137 | $36K |
| 18 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $36K |
| 19 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $35K |
| 20 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $32K |
Showing top 20 of 223 providers billing this code