Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#6512 of 11K

85362

HCPCS Procedure Code

HCPCS code 85362 is the #6,512 most-billed Medicaid procedure code, with $60K in payments across 30K claims from 2018–2024. The national median cost per claim is $0.97. Costs vary widely — the 90th percentile is $4.42 per claim, 4.6× the median.

Total Paid

$60K

0.00% of all spending

Total Claims

30K

Providers

41

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for 85362? Based on 38 providers billing this code nationally.

Median

$0.97

Average

$2.02

Std Dev

$3.74

Max

$21.37

Percentile Distribution (Cost per Claim)

p10
$0.31
p25
$0.64
Median
$0.97
p75
$1.41
p90
$4.42
p95
$6.50
p99
$17.22

50% of providers bill between $0.64 and $1.41 per claim for this code.

90% bill between $0.31 and $4.42.

Top 1% bill above $17.22.

About This Procedure

HCPCS code 85362 was billed by 41 providers across 30K claims, totaling $60K in Medicaid payments from 2018–2024. This code was used for 26K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.97

Providers Billing

38

National Spending

$60K

Avg/Median Ratio

2.08×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 85362

#ProviderTotal Paid
11447221742$18K
2Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$13K
3Antelope Valley Health Care District

Lancaster, CA · General Acute Care Hospital

$11K
4Bronxcare Health System

Bronx, NY · General Acute Care Hospital

$3K
51700474608$2K
61376564641$2K
71942257191$2K
81598760985$1K
91821250762$1K
101184618829$1K
111184654923$1K
121972582062$807
131699757369$460
141083712525$415
151730119553$358
161295797355$297
171912172024$142
181689635773$138
191487697215$131
201841220704$118

Showing top 20 of 41 providers billing this code

Related Procedures