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#4437 of 11K

85247

HCPCS Procedure Code

HCPCS code 85247 is the #4,437 most-billed Medicaid procedure code, with $592K in payments across 54K claims from 2018–2024. The national median cost per claim is $13.19. Costs vary widely — the 90th percentile is $31.17 per claim, 2.4× the median.

Total Paid

$592K

0.00% of all spending

Total Claims

54K

Providers

63

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for 85247? Based on 62 providers billing this code nationally.

Median

$13.19

Average

$15.02

Std Dev

$11.83

Max

$65.37

Percentile Distribution (Cost per Claim)

p10
$3.41
p25
$7.59
Median
$13.19
p75
$18.76
p90
$31.17
p95
$34.95
p99
$57.36

50% of providers bill between $7.59 and $18.76 per claim for this code.

90% bill between $3.41 and $31.17.

Top 1% bill above $57.36.

About This Procedure

HCPCS code 85247 was billed by 63 providers across 54K claims, totaling $592K in Medicaid payments from 2018–2024. This code was used for 51K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.19

Providers Billing

62

National Spending

$592K

Avg/Median Ratio

1.14×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 85247

#ProviderTotal Paid
1Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$68K
21447296272$64K
3Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$61K
4Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$49K
5Quest Diagnostics Clinical Laboratories Inc

Irving, TX · Clinical Medical Laboratory

$45K
61780620526$31K
7Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$23K
8Unilab Corporation

Sacramento, CA · Clinical Medical Laboratory

$21K
91891731626$20K
10Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$18K
11Upmc Children's Hospital Of Pittsburgh

Pittsburgh, PA · Clinic/Center

$18K
12Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$16K
13Quest Diagnostics Llc Il

Wood Dale, IL · Clinical Medical Laboratory

$16K
14Quest Diagnostics Clinical Laboratories Inc

Tucker, GA · Clinical Medical Laboratory

$15K
15Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$13K
16Quest Diagnostics Incorporated

Las Vegas, NV · Clinical Medical Laboratory

$12K
17Dayton Children's Hospital

Dayton, OH · General Acute Care Hospital, Children

$10K
18Labone Llc

Lenexa, KS · Clinical Medical Laboratory

$10K
19Laboratory Corporation Of America

Tampa, FL · Clinical Medical Laboratory

$8K
201891873303$8K

Showing top 20 of 63 providers billing this code