85049
HCPCS Procedure Code
HCPCS code 85049 is the #3,709 most-billed Medicaid procedure code, with $1.3M in payments across 709K claims from 2018–2024. The national median cost per claim is $1.68. Costs vary widely — the 90th percentile is $5.24 per claim, 3.1× the median.
Total Paid
$1.3M
0.00% of all spending
Total Claims
709K
Providers
436
Avg Cost/Claim
$2
National Cost Distribution
How much do providers bill per claim for 85049? Based on 384 providers billing this code nationally.
Median
$1.68
Average
$4.50
Std Dev
$15.98
Max
$192.79
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.70 and $3.33 per claim for this code.
90% bill between $0.22 and $5.24.
Top 1% bill above $74.10.
About This Procedure
HCPCS code 85049 was billed by 436 providers across 709K claims, totaling $1.3M in Medicaid payments from 2018–2024. This code was used for 636K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$1.68
Providers Billing
384
National Spending
$1.3M
Avg/Median Ratio
2.68×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 85049
| # | Provider | Total Paid |
|---|---|---|
| 1 | Dallas County Hospital District Dallas, TX · Clinic/Center, Ambulatory Surgical | $294K |
| 2 | 1346522679 | $70K |
| 3 | 1710378120 | $60K |
| 4 | 1437150984 | $50K |
| 5 | 1578895082 | $49K |
| 6 | 1003810375 | $39K |
| 7 | Group Health Plan, Inc. Minneapolis, MN · Clinic/Center, Multi-Specialty | $34K |
| 8 | 1467807180 | $33K |
| 9 | 1487739447 | $31K |
| 10 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $25K |
| 11 | Quest Diagnostics Incorporated Md Baltimore, MD · Clinical Medical Laboratory | $25K |
| 12 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $25K |
| 13 | Froedtert Memorial Lutheran Hospital, Inc. Milwaukee, WI · Clinic/Center, Radiology | $23K |
| 14 | 1598266421 | $23K |
| 15 | University Of Wisconsin Hospitals And Clinics Authority Madison, WI · General Acute Care Hospital | $17K |
| 16 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $14K |
| 17 | 1164493847 | $14K |
| 18 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $12K |
| 19 | 1962463786 | $12K |
| 20 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $12K |
Showing top 20 of 436 providers billing this code