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#7652 of 11K

85612

HCPCS Procedure Code

HCPCS code 85612 is the #7,652 most-billed Medicaid procedure code, with $13K in payments across 1,697 claims from 2018–2024. The national median cost per claim is $5.04. Costs vary widely — the 90th percentile is $19.73 per claim, 3.9× the median.

Total Paid

$13K

0.00% of all spending

Total Claims

1,697

Providers

8

Avg Cost/Claim

$7

National Cost Distribution

How much do providers bill per claim for 85612? Based on 8 providers billing this code nationally.

Median

$5.04

Average

$9.87

Std Dev

$9.76

Max

$31.14

Percentile Distribution (Cost per Claim)

p10
$3.14
p25
$3.70
Median
$5.04
p75
$13.54
p90
$19.73
p95
$25.44
p99
$30.00

50% of providers bill between $3.70 and $13.54 per claim for this code.

90% bill between $3.14 and $19.73.

Top 1% bill above $30.00.

About This Procedure

HCPCS code 85612 was billed by 8 providers across 1,697 claims, totaling $13K in Medicaid payments from 2018–2024. This code was used for 1,385 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.04

Providers Billing

8

National Spending

$13K

Avg/Median Ratio

1.96×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 85612

#ProviderTotal Paid
11376577247$4K
2Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$4K
3University Of Kentucky

Lexington, KY · General Acute Care Hospital

$2K
4Rector & Visitors Of The University Of Virginia

Charlottesville, VA · General Acute Care Hospital

$903
5The Miriam Hospital

Providence, RI · General Acute Care Hospital

$810
6Beth Israel Medical Center

Brooklyn, NY · Psychiatric Unit

$674
7The Good Samaritan Hospital Of Cincinnati, Ohio

Cincinnati, OH · General Acute Care Hospital

$128
8St Lukes Roosevelt Hospital Center

New York, NY · Case Management

$31

Showing top 8 of 8 providers billing this code