85611
HCPCS Procedure Code
HCPCS code 85611 is the #7,545 most-billed Medicaid procedure code, with $15K in payments across 5,604 claims from 2018–2024. The national median cost per claim is $3.18. Costs vary widely — the 90th percentile is $6.65 per claim, 2.1× the median.
Total Paid
$15K
0.00% of all spending
Total Claims
5,604
Providers
12
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for 85611? Based on 12 providers billing this code nationally.
Median
$3.18
Average
$3.53
Std Dev
$2.19
Max
$6.78
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.01 and $4.95 per claim for this code.
90% bill between $1.11 and $6.65.
Top 1% bill above $6.77.
About This Procedure
HCPCS code 85611 was billed by 12 providers across 5,604 claims, totaling $15K in Medicaid payments from 2018–2024. This code was used for 4,899 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$3.18
Providers Billing
12
National Spending
$15K
Avg/Median Ratio
1.11×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 85611
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1396087672 | $6K |
| 2 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $3K |
| 3 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $2K |
| 4 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $2K |
| 5 | 1598760985 | $2K |
| 6 | 1154428688 | $393 |
| 7 | Orchard Laboratories Corp West Bloomfield, MI · Clinical Medical Laboratory | $321 |
| 8 | 1023636545 | $129 |
| 9 | 1659585370 | $58 |
| 10 | 1902131857 | $44 |
| 11 | 1629454053 | $34 |
| 12 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $24 |
Showing top 12 of 12 providers billing this code