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#668 of 11K

85018

HCPCS Procedure Code

HCPCS code 85018 is the #668 most-billed Medicaid procedure code, with $109.9M in payments across 31.8M claims from 2018–2024. The national median cost per claim is $1.71.

Total Paid

$109.9M

0.01% of all spending

Total Claims

31.8M

Providers

14K

Avg Cost/Claim

$3

National Cost Distribution

How much do providers bill per claim for 85018? Based on 12K providers billing this code nationally.

Median

$1.71

Average

$4.32

Std Dev

$23.35

Max

$945.00

Percentile Distribution (Cost per Claim)

p10
$0.07
p25
$0.53
Median
$1.71
p75
$2.29
p90
$2.89
p95
$5.68
p99
$113.64

50% of providers bill between $0.53 and $2.29 per claim for this code.

90% bill between $0.07 and $2.89.

Top 1% bill above $113.64.

About This Procedure

HCPCS code 85018 was billed by 14K providers across 31.8M claims, totaling $109.9M in Medicaid payments from 2018–2024. This code was used for 24.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1.71

Providers Billing

12K

National Spending

$109.9M

Avg/Median Ratio

2.53×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 85018

#ProviderTotal Paid
1Texas Department Of State Health

Austin, TX · Clinical Medical Laboratory

$1.6M
2Renal Care Group Of The Southeast Inc.

Pensacola, FL · Clinic/Center End-Stage Renal Disease (ESRD) Treatment

$1.4M
31609988450$1.1M
41942293691$1.1M
51790897551$1.1M
6Spartanburg Medical Center

Spartanburg, SC · Ambulance

$1.0M
71437168440$1.0M
81356453195$1.0M
91861504607$1.0M
101811009665$971K
111457449282$956K
121619089463$930K
131336251198$920K
141801908652$896K
151528170388$876K
161083726822$868K
171912372293$862K
181376588046$860K
191780771998$843K
201891807657$824K

Showing top 20 of 14K providers billing this code