85613
HCPCS Procedure Code
HCPCS code 85613 is the #3,330 most-billed Medicaid procedure code, with $1.9M in payments across 370K claims from 2018–2024. The national median cost per claim is $6.10.
Total Paid
$1.9M
0.00% of all spending
Total Claims
370K
Providers
280
Avg Cost/Claim
$5
National Cost Distribution
How much do providers bill per claim for 85613? Based on 273 providers billing this code nationally.
Median
$6.10
Average
$6.74
Std Dev
$5.86
Max
$65.06
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.96 and $8.40 per claim for this code.
90% bill between $1.56 and $11.08.
Top 1% bill above $29.49.
About This Procedure
HCPCS code 85613 was billed by 280 providers across 370K claims, totaling $1.9M in Medicaid payments from 2018–2024. This code was used for 345K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$6.10
Providers Billing
273
National Spending
$1.9M
Avg/Median Ratio
1.10×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 85613
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $390K |
| 2 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $121K |
| 3 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $110K |
| 4 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $65K |
| 5 | Laboratory Corporation Of America Phoenix, AZ · Clinical Medical Laboratory | $60K |
| 6 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $49K |
| 7 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $47K |
| 8 | 1447296272 | $40K |
| 9 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $40K |
| 10 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $38K |
| 11 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $33K |
| 12 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $31K |
| 13 | A2cl Services, Llc West Allis, WI · Clinical Medical Laboratory | $31K |
| 14 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $28K |
| 15 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $28K |
| 16 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $26K |
| 17 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $26K |
| 18 | Nyu Langone Hospitals New York, NY · Clinic/Center, Oncology | $24K |
| 19 | 1215914585 | $23K |
| 20 | Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory | $20K |
Showing top 20 of 280 providers billing this code