85999
HCPCS Procedure Code
HCPCS code 85999 is the #5,711 most-billed Medicaid procedure code, with $150K in payments across 32K claims from 2018–2024. The national median cost per claim is $3.01.
Total Paid
$150K
0.00% of all spending
Total Claims
32K
Providers
108
Avg Cost/Claim
$5
National Cost Distribution
How much do providers bill per claim for 85999? Based on 103 providers billing this code nationally.
Median
$3.01
Average
$3.10
Std Dev
$2.88
Max
$23.71
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.87 and $3.01 per claim for this code.
90% bill between $1.61 and $3.01.
Top 1% bill above $20.52.
About This Procedure
HCPCS code 85999 was billed by 108 providers across 32K claims, totaling $150K in Medicaid payments from 2018–2024. This code was used for 32K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$3.01
Providers Billing
103
National Spending
$150K
Avg/Median Ratio
1.03×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 85999
| # | Provider | Total Paid |
|---|---|---|
| 1 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $35K |
| 2 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $29K |
| 3 | 1568495364 | $10K |
| 4 | 1073793790 | $5K |
| 5 | 1992732192 | $5K |
| 6 | 1689744450 | $5K |
| 7 | 1740427657 | $3K |
| 8 | 1508073685 | $3K |
| 9 | 1871818138 | $3K |
| 10 | 1912921164 | $3K |
| 11 | 1235376047 | $3K |
| 12 | 1891860748 | $3K |
| 13 | 1760651814 | $3K |
| 14 | 1366592982 | $2K |
| 15 | 1427121375 | $2K |
| 16 | 1083851992 | $2K |
| 17 | 1265569008 | $2K |
| 18 | 1316116221 | $2K |
| 19 | 1144325259 | $2K |
| 20 | 1598790529 | $2K |
Showing top 20 of 108 providers billing this code