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#7867 of 11K

85635

HCPCS Procedure Code

HCPCS code 85635 is the #7,867 most-billed Medicaid procedure code, with $9K in payments across 1,350 claims from 2018–2024. The national median cost per claim is $7.31. Costs vary widely — the 90th percentile is $16.04 per claim, 2.2× the median.

Total Paid

$9K

0.00% of all spending

Total Claims

1,350

Providers

4

Avg Cost/Claim

$7

National Cost Distribution

How much do providers bill per claim for 85635? Based on 4 providers billing this code nationally.

Median

$7.31

Average

$9.78

Std Dev

$6.55

Max

$19.42

Percentile Distribution (Cost per Claim)

p10
$5.49
p25
$6.12
Median
$7.31
p75
$10.98
p90
$16.04
p95
$17.73
p99
$19.08

50% of providers bill between $6.12 and $10.98 per claim for this code.

90% bill between $5.49 and $16.04.

Top 1% bill above $19.08.

About This Procedure

HCPCS code 85635 was billed by 4 providers across 1,350 claims, totaling $9K in Medicaid payments from 2018–2024. This code was used for 935 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.31

Providers Billing

4

National Spending

$9K

Avg/Median Ratio

1.34×

Normal distribution

Provider Coverage

We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.