#2040 of 11K

85060

HCPCS Procedure Code

HCPCS code 85060 is the #2,040 most-billed Medicaid procedure code, with $9.8M in payments across 978K claims from 2018–2024. The national median cost per claim is $10.92.

Total Paid

$9.8M

0.00% of all spending

Total Claims

978K

Providers

822

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for 85060? Based on 794 providers billing this code nationally.

Median

$10.92

Average

$11.13

Std Dev

$5.63

Max

$47.13

Percentile Distribution (Cost per Claim)

p10

$4.07

p25

$7.99

Median

$10.92

p75

$13.82

p90

$17.80

p95

$21.10

p99

$27.93

50% of providers bill between $7.99 and $13.82 per claim for this code.

90% bill between $4.07 and $17.80.

Top 1% bill above $27.93.

About This Procedure

HCPCS code 85060 was billed by 822 providers across 978K claims, totaling $9.8M in Medicaid payments from 2018–2024. This code was used for 869K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$10.92

Providers Billing

794

National Spending

$9.8M

Avg/Median Ratio

1.02×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 85060

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1366499733	$487K	$12.54	1.1× median	Above Median
2	1255354130	$306K	$17.13	1.6× median	Above 75th
3	1174503999	$182K	$17.81	1.6× median	Top 10%
4	1043275787	$168K	$18.31	1.7× median	Top 10%
5	Yale University New Haven, CT · Internal Medicine	$149K	$10.00	0.9× median	Below Median
6	Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory	$141K	$8.12	0.7× median	Below Median
7	Unilab Corporation West Hills, CA · Clinical Medical Laboratory	$132K	$3.42	0.3× median	Below Median
8	1033173182	$122K	$15.28	1.4× median	Above 75th
9	Laboratory Corporation Of America Seattle, WA · Clinical Medical Laboratory	$117K	$11.48	1.1× median	Above Median
10	1831218627	$101K	$20.08	1.8× median	Top 10%
11	1972596864	$100K	$10.02	0.9× median	Below Median
12	1285890863	$100K	$9.01	0.8× median	Below Median
13	Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory	$99K	$10.93	1.0× median	Above Median
14	1699720086	$95K	$14.95	1.4× median	Above 75th
15	1457308637	$93K	$12.70	1.2× median	Above Median
16	Labone Llc Lenexa, KS · Clinical Medical Laboratory	$90K	$14.38	1.3× median	Above 75th
17	Cook Children's Physician Network Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.)	$89K	$12.99	1.2× median	Above Median
18	1891797148	$84K	$14.29	1.3× median	Above 75th
19	Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory	$83K	$8.36	0.8× median	Below Median
20	1962735399	$82K	$8.44	0.8× median	Below Median

Showing top 20 of 822 providers billing this code

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