#3968 of 11K

77085

HCPCS Procedure Code

HCPCS code 77085 is the #3,968 most-billed Medicaid procedure code, with $973K in payments across 27K claims from 2018–2024. The national median cost per claim is $21.98. Costs vary widely — the 90th percentile is $60.65 per claim, 2.8× the median.

Total Paid

$973K

0.00% of all spending

Total Claims

27K

Providers

Avg Cost/Claim

$36

National Cost Distribution

How much do providers bill per claim for 77085? Based on 95 providers billing this code nationally.

Median

$21.98

Average

$31.98

Std Dev

$38.57

Max

$242.61

Percentile Distribution (Cost per Claim)

p10

$3.80

p25

$7.91

Median

$21.98

p75

$45.94

p90

$60.65

p95

$90.97

p99

$212.69

50% of providers bill between $7.91 and $45.94 per claim for this code.

90% bill between $3.80 and $60.65.

Top 1% bill above $212.69.

About This Procedure

HCPCS code 77085 was billed by 99 providers across 27K claims, totaling $973K in Medicaid payments from 2018–2024. This code was used for 26K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$21.98

Providers Billing

National Spending

$973K

Avg/Median Ratio

1.45×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 77085

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Lenox Hill Radiology & Medical Imaging Associates, Pc New York, NY · Radiology, Body Imaging	$178K	$46.40	2.1× median	Above 75th
2	1366459570	$165K	$210.78	9.6× median	Top 10%
3	University Hospital Newark, NJ · General Acute Care Hospital	$113K	$46.78	2.1× median	Above 75th
4	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$81K	$111.04	5.1× median	Top 10%
5	New York Network Ipa Inc Brooklyn, NY · Exclusive Provider Organization	$69K	$51.27	2.3× median	Above 75th
6	1285630129	$25K	$27.24	1.2× median	Above Median
7	1316957913	$24K	$21.98	1.0× median	Above Median
8	1477616571	$21K	$242.61	11.0× median	Top 1%
9	1477549756	$21K	$15.45	0.7× median	Below Median
10	1114984671	$20K	$45.49	2.1× median	Above Median
11	1518018191	$19K	$62.14	2.8× median	Top 10%
12	Saint Mary's Hospital, Inc. Waterbury, CT · General Acute Care Hospital	$18K	$60.55	2.8× median	Above 75th
13	1740283324	$16K	$7.28	0.3× median	Below Median
14	1396087672	$14K	$49.89	2.3× median	Above 75th
15	1255755823	$14K	$51.85	2.4× median	Above 75th
16	1386714962	$13K	$9.28	0.4× median	Below Median
17	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$13K	$46.92	2.1× median	Above 75th
18	Kennedy University Hospital Inc. Stratford, NJ · General Acute Care Hospital	$13K	$31.68	1.4× median	Above Median
19	1164841979	$9K	$19.98	0.9× median	Below Median
20	1487995700	$9K	$62.50	2.8× median	Top 10%

Showing top 20 of 99 providers billing this code

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