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#2792 of 11K

90685

HCPCS Procedure Code

HCPCS code 90685 is the #2,792 most-billed Medicaid procedure code, with $3.6M in payments across 977K claims from 2018–2024. The national median cost per claim is $5.96. Costs vary widely — the 90th percentile is $17.66 per claim, 3.0× the median.

Total Paid

$3.6M

0.00% of all spending

Total Claims

977K

Providers

5,187

Avg Cost/Claim

$4

National Cost Distribution

How much do providers bill per claim for 90685? Based on 2,732 providers billing this code nationally.

Median

$5.96

Average

$7.38

Std Dev

$10.62

Max

$270.47

Percentile Distribution (Cost per Claim)

p10
$0.16
p25
$1.01
Median
$5.96
p75
$10.54
p90
$17.66
p95
$20.11
p99
$27.17

50% of providers bill between $1.01 and $10.54 per claim for this code.

90% bill between $0.16 and $17.66.

Top 1% bill above $27.17.

About This Procedure

HCPCS code 90685 was billed by 5,187 providers across 977K claims, totaling $3.6M in Medicaid payments from 2018–2024. This code was used for 910K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.96

Providers Billing

2,732

National Spending

$3.6M

Avg/Median Ratio

1.24×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 90685

#ProviderTotal Paid
11811091952$92K
2Nyu Langone Hospitals

Brooklyn, NY · General Acute Care Hospital

$84K
3Children's Hospital Medical Center Of Akron

Akron, OH · General Acute Care Hospital Children

$74K
41568576056$66K
5Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$50K
61922291996$48K
71376593442$37K
8The Nemours Foundation

Wilmington, DE · Clinic/Center, Developmental Disabilities

$36K
91235131632$35K
101306873500$33K
111245307693$33K
121124105762$32K
131710945969$32K
141407877137$31K
151790879971$27K
16University Of Utah

Salt Lake City, UT · Clinic/Center, Dental

$27K
171699087403$26K
181811362908$25K
191497841571$24K
20Children's Hospital Corporation

Boston, MA · Clinic/Center

$20K

Showing top 20 of 5,187 providers billing this code