85730
HCPCS Procedure Code
HCPCS code 85730 is the #987 most-billed Medicaid procedure code, with $50.7M in payments across 17.9M claims from 2018–2024. The national median cost per claim is $2.83. Costs vary widely — the 90th percentile is $6.35 per claim, 2.2× the median.
Total Paid
$50.7M
0.00% of all spending
Total Claims
17.9M
Providers
4,618
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for 85730? Based on 4,342 providers billing this code nationally.
Median
$2.83
Average
$4.35
Std Dev
$11.12
Max
$324.06
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.92 and $4.72 per claim for this code.
90% bill between $0.29 and $6.35.
Top 1% bill above $40.51.
About This Procedure
HCPCS code 85730 was billed by 4,618 providers across 17.9M claims, totaling $50.7M in Medicaid payments from 2018–2024. This code was used for 15.0M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$2.83
Providers Billing
4,342
National Spending
$50.7M
Avg/Median Ratio
1.54×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 85730
| # | Provider | Total Paid |
|---|---|---|
| 1 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $828K |
| 2 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $749K |
| 3 | Truman Medical Center, Incorporated Kansas City, MO · General Acute Care Hospital | $580K |
| 4 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $472K |
| 5 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $430K |
| 6 | The Miriam Hospital Providence, RI · General Acute Care Hospital | $350K |
| 7 | 1609869916 | $347K |
| 8 | Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital | $338K |
| 9 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $328K |
| 10 | 1467412726 | $319K |
| 11 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $311K |
| 12 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $302K |
| 13 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $292K |
| 14 | St. Mary's Medical Center Inc Huntington, WV · General Acute Care Hospital | $282K |
| 15 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $229K |
| 16 | 1750332565 | $220K |
| 17 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $219K |
| 18 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $209K |
| 19 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $205K |
| 20 | 1457354656 | $202K |
Showing top 20 of 4,618 providers billing this code