85245
HCPCS Procedure Code
HCPCS code 85245 is the #3,264 most-billed Medicaid procedure code, with $2.1M in payments across 184K claims from 2018–2024. The national median cost per claim is $14.50. Costs vary widely — the 90th percentile is $29.27 per claim, 2.0× the median.
Total Paid
$2.1M
0.00% of all spending
Total Claims
184K
Providers
154
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for 85245? Based on 151 providers billing this code nationally.
Median
$14.50
Average
$16.76
Std Dev
$12.47
Max
$79.85
Percentile Distribution (Cost per Claim)
50% of providers bill between $8.18 and $20.34 per claim for this code.
90% bill between $4.29 and $29.27.
Top 1% bill above $64.66.
About This Procedure
HCPCS code 85245 was billed by 154 providers across 184K claims, totaling $2.1M in Medicaid payments from 2018–2024. This code was used for 175K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$14.50
Providers Billing
151
National Spending
$2.1M
Avg/Median Ratio
1.16×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 85245
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $312K |
| 2 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $87K |
| 3 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $87K |
| 4 | 1447296272 | $86K |
| 5 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $70K |
| 6 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $64K |
| 7 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $62K |
| 8 | Laboratory Corporation Of America Phoenix, AZ · Clinical Medical Laboratory | $58K |
| 9 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $57K |
| 10 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $52K |
| 11 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $51K |
| 12 | 1780620526 | $49K |
| 13 | Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory | $49K |
| 14 | 1629109137 | $47K |
| 15 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $46K |
| 16 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $38K |
| 17 | Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory | $38K |
| 18 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $33K |
| 19 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $32K |
| 20 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $30K |
Showing top 20 of 154 providers billing this code