85378
HCPCS Procedure Code
HCPCS code 85378 is the #3,599 most-billed Medicaid procedure code, with $1.4M in payments across 389K claims from 2018–2024. The national median cost per claim is $3.49. Costs vary widely — the 90th percentile is $11.28 per claim, 3.2× the median.
Total Paid
$1.4M
0.00% of all spending
Total Claims
389K
Providers
364
Avg Cost/Claim
$4
National Cost Distribution
How much do providers bill per claim for 85378? Based on 345 providers billing this code nationally.
Median
$3.49
Average
$6.18
Std Dev
$12.08
Max
$138.60
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.15 and $6.31 per claim for this code.
90% bill between $0.50 and $11.28.
Top 1% bill above $54.40.
About This Procedure
HCPCS code 85378 was billed by 364 providers across 389K claims, totaling $1.4M in Medicaid payments from 2018–2024. This code was used for 337K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$3.49
Providers Billing
345
National Spending
$1.4M
Avg/Median Ratio
1.77×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 85378
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1780681189 | $41K |
| 2 | 1003831132 | $39K |
| 3 | 1922008150 | $38K |
| 4 | 1891792495 | $35K |
| 5 | 1679879589 | $30K |
| 6 | 1750332565 | $30K |
| 7 | 1821147786 | $29K |
| 8 | 1548246622 | $29K |
| 9 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $27K |
| 10 | 1467669259 | $26K |
| 11 | 1306339460 | $26K |
| 12 | 1861409823 | $25K |
| 13 | 1609869916 | $23K |
| 14 | 1255430757 | $22K |
| 15 | 1811213994 | $20K |
| 16 | 1801104732 | $20K |
| 17 | 1457309247 | $19K |
| 18 | 1407813660 | $19K |
| 19 | Trinitas Regional Medical Center Elizabeth, NJ · General Acute Care Hospital | $18K |
| 20 | 1952476665 | $18K |
Showing top 20 of 364 providers billing this code