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#3200 of 11K

85390

HCPCS Procedure Code

HCPCS code 85390 is the #3,200 most-billed Medicaid procedure code, with $2.2M in payments across 202K claims from 2018–2024. The national median cost per claim is $9.12. Costs vary widely — the 90th percentile is $27.78 per claim, 3.0× the median.

Total Paid

$2.2M

0.00% of all spending

Total Claims

202K

Providers

162

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for 85390? Based on 159 providers billing this code nationally.

Median

$9.12

Average

$12.83

Std Dev

$13.19

Max

$102.81

Percentile Distribution (Cost per Claim)

p10
$1.97
p25
$4.12
Median
$9.12
p75
$17.86
p90
$27.78
p95
$31.57
p99
$61.20

50% of providers bill between $4.12 and $17.86 per claim for this code.

90% bill between $1.97 and $27.78.

Top 1% bill above $61.20.

About This Procedure

HCPCS code 85390 was billed by 162 providers across 202K claims, totaling $2.2M in Medicaid payments from 2018–2024. This code was used for 143K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.12

Providers Billing

159

National Spending

$2.2M

Avg/Median Ratio

1.41×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 85390

#ProviderTotal Paid
11487600334$314K
2Montefiore Medical Center

Bronx, NY · Anesthesiology

$186K
3The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$167K
41033535497$135K
51801874573$117K
61831218627$89K
7Florida Clinical Practice Association Inc

Gainesville, FL · Surgery

$86K
81073622544$77K
91457389033$58K
101326389826$56K
11Mayo Collaborative Services, Inc

Rochester, MN · Clinical Medical Laboratory

$51K
12Vanderbilt University Medical Center

Nashville, TN · Transplant Surgery

$47K
131083675169$47K
14Phoenix Children's Hospital

Phoenix, AZ · Pediatrics

$40K
151336223635$39K
16Yale University

New Haven, CT · Internal Medicine

$38K
171871101238$36K
18Tricore Reference Laboratories

Albuquerque, NM · Clinical Medical Laboratory

$34K
19A2cl Services, Llc

West Allis, WI · Clinical Medical Laboratory

$31K
201790732360$30K

Showing top 20 of 162 providers billing this code