85246
HCPCS Procedure Code
HCPCS code 85246 is the #2,990 most-billed Medicaid procedure code, with $2.8M in payments across 226K claims from 2018–2024. The national median cost per claim is $15.06.
Total Paid
$2.8M
0.00% of all spending
Total Claims
226K
Providers
187
Avg Cost/Claim
$12
National Cost Distribution
How much do providers bill per claim for 85246? Based on 185 providers billing this code nationally.
Median
$15.06
Average
$17.49
Std Dev
$21.34
Max
$260.47
Percentile Distribution (Cost per Claim)
50% of providers bill between $8.42 and $20.30 per claim for this code.
90% bill between $4.57 and $27.03.
Top 1% bill above $70.23.
About This Procedure
HCPCS code 85246 was billed by 187 providers across 226K claims, totaling $2.8M in Medicaid payments from 2018–2024. This code was used for 214K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$15.06
Providers Billing
185
National Spending
$2.8M
Avg/Median Ratio
1.16×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 85246
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $330K |
| 2 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $138K |
| 3 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $116K |
| 4 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $107K |
| 5 | 1447296272 | $94K |
| 6 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $94K |
| 7 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $89K |
| 8 | Children's Hospital Corporation Boston, MA · Clinic/Center | $86K |
| 9 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $78K |
| 10 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $67K |
| 11 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $64K |
| 12 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $62K |
| 13 | Laboratory Corporation Of America Phoenix, AZ · Clinical Medical Laboratory | $59K |
| 14 | 1700949336 | $57K |
| 15 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $57K |
| 16 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $53K |
| 17 | 1780620526 | $48K |
| 18 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $46K |
| 19 | 1629109137 | $39K |
| 20 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $39K |
Showing top 20 of 187 providers billing this code