85250
HCPCS Procedure Code
HCPCS code 85250 is the #5,739 most-billed Medicaid procedure code, with $147K in payments across 14K claims from 2018–2024. The national median cost per claim is $9.36. Costs vary widely — the 90th percentile is $25.16 per claim, 2.7× the median.
Total Paid
$147K
0.00% of all spending
Total Claims
14K
Providers
41
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for 85250? Based on 39 providers billing this code nationally.
Median
$9.36
Average
$12.67
Std Dev
$10.95
Max
$47.60
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.28 and $15.88 per claim for this code.
90% bill between $2.57 and $25.16.
Top 1% bill above $45.69.
About This Procedure
HCPCS code 85250 was billed by 41 providers across 14K claims, totaling $147K in Medicaid payments from 2018–2024. This code was used for 13K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$9.36
Providers Billing
39
National Spending
$147K
Avg/Median Ratio
1.35×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 85250
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $35K |
| 2 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $34K |
| 3 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $23K |
| 4 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $8K |
| 5 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $6K |
| 6 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $6K |
| 7 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $5K |
| 8 | Permanente Medical Group, Inc. Richmond, CA · Clinical Medical Laboratory | $4K |
| 9 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $3K |
| 10 | Connecticut Children's Medical Center Hartford, CT · General Acute Care Hospital, Children | $3K |
| 11 | Laboratory Corporation Of America Phoenix, AZ · Clinical Medical Laboratory | $3K |
| 12 | 1619069416 | $2K |
| 13 | Maimonides Medical Center Brooklyn, NY · General Acute Care Hospital | $1K |
| 14 | 1073587937 | $1K |
| 15 | 1699720086 | $1K |
| 16 | Vhs Childrens Hospital Of Michigan Inc Detroit, MI · Clinic/Center, Ambulatory Surgical | $1K |
| 17 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $945 |
| 18 | Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory | $846 |
| 19 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $833 |
| 20 | 1629109137 | $821 |
Showing top 20 of 41 providers billing this code