85007
HCPCS Procedure Code
HCPCS code 85007 is the #1,943 most-billed Medicaid procedure code, with $11.2M in payments across 4.4M claims from 2018–2024. The national median cost per claim is $1.77. Costs vary widely — the 90th percentile is $4.72 per claim, 2.7× the median.
Total Paid
$11.2M
0.00% of all spending
Total Claims
4.4M
Providers
2K
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for 85007? Based on 2K providers billing this code nationally.
Median
$1.77
Average
$3.10
Std Dev
$7.21
Max
$157.01
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.64 and $3.10 per claim for this code.
90% bill between $0.22 and $4.72.
Top 1% bill above $31.54.
About This Procedure
HCPCS code 85007 was billed by 2K providers across 4.4M claims, totaling $11.2M in Medicaid payments from 2018–2024. This code was used for 3.3M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$1.77
Providers Billing
2K
National Spending
$11.2M
Avg/Median Ratio
1.75×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 85007
| # | Provider | Total Paid |
|---|---|---|
| 1 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $634K |
| 2 | Driscoll Childrens Hospital Corpus Christi, TX · Speech-Language Pathologist, | $475K |
| 3 | Children's Health System Of Texas Dallas, TX · General Acute Care Hospital Children | $389K |
| 4 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $270K |
| 5 | The Miriam Hospital Providence, RI · General Acute Care Hospital | $234K |
| 6 | 1790740363 | $194K |
| 7 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $134K |
| 8 | 1699704254 | $115K |
| 9 | Robert Wood Johnson University Hospital, Inc New Brunswick, NJ · General Acute Care Hospital | $109K |
| 10 | 1700949336 | $106K |
| 11 | Childrens Hospital Of Los Angeles Los Angeles, CA · Case Manager/Care Coordinator | $101K |
| 12 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $100K |
| 13 | Newark Beth Israel Medical Center Inc Newark, NJ · General Acute Care Hospital | $97K |
| 14 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $84K |
| 15 | Spartanburg Medical Center Spartanburg, SC · Ambulance | $81K |
| 16 | Dayton Children's Hospital Dayton, OH · General Acute Care Hospital, Children | $81K |
| 17 | Johns Hopkins All Children's Hospital Inc St Petersburg, FL · General Acute Care Hospital Children | $79K |
| 18 | 1437135902 | $78K |
| 19 | 1255875746 | $73K |
| 20 | Children's Hospital Corporation Boston, MA · Clinic/Center | $71K |
Showing top 20 of 2K providers billing this code