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#1415 of 11K

85379

HCPCS Procedure Code

HCPCS code 85379 is the #1,415 most-billed Medicaid procedure code, with $23.9M in payments across 5.2M claims from 2018–2024. The national median cost per claim is $4.29. Costs vary widely — the 90th percentile is $10.91 per claim, 2.5× the median.

Total Paid

$23.9M

0.00% of all spending

Total Claims

5.2M

Providers

3,271

Avg Cost/Claim

$5

National Cost Distribution

How much do providers bill per claim for 85379? Based on 3,079 providers billing this code nationally.

Median

$4.29

Average

$6.45

Std Dev

$11.15

Max

$160.99

Percentile Distribution (Cost per Claim)

p10
$0.36
p25
$1.25
Median
$4.29
p75
$7.50
p90
$10.91
p95
$18.84
p99
$55.35

50% of providers bill between $1.25 and $7.50 per claim for this code.

90% bill between $0.36 and $10.91.

Top 1% bill above $55.35.

About This Procedure

HCPCS code 85379 was billed by 3,271 providers across 5.2M claims, totaling $23.9M in Medicaid payments from 2018–2024. This code was used for 4.6M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$4.29

Providers Billing

3,079

National Spending

$23.9M

Avg/Median Ratio

1.50×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 85379

#ProviderTotal Paid
1The Miriam Hospital

Providence, RI · General Acute Care Hospital

$247K
2Aurora Health Care Metro, Inc.

Milwaukee, WI · Internal Medicine, Hematology & Oncology

$203K
3Charleston Area Medical Center Inc

Charleston, WV · General Acute Care Hospital

$203K
4Grossmont Hospital Corporation

La Mesa, CA · General Acute Care Hospital

$171K
5Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$154K
6Sharp Memorial Hospital

San Diego, CA · General Acute Care Hospital, Women

$147K
7Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$147K
8Presbyterian Healthcare Services

Albuquerque, NM · Emergency Medicine

$146K
9Laboratory Corporation Of America Holdings

Dublin, OH · Clinical Medical Laboratory

$145K
101144664954$140K
111891075446$135K
121710109186$130K
13Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$129K
14Sharp Chula Vista Medical Center

Chula Vista, CA · General Acute Care Hospital

$127K
15University Of Kentucky

Lexington, KY · General Acute Care Hospital

$119K
16Mid Atlantic Pemanente Medical Group

Rockville, MD · Health Maintenance Organization

$113K
171013954437$110K
18Stanford Health Care

Stanford, CA · General Acute Care Hospital

$109K
191598736159$108K
20Arrowhead Regional Medical Center

Colton, CA · General Acute Care Hospital

$108K

Showing top 20 of 3,271 providers billing this code