0164A
HCPCS Procedure Code
HCPCS code 0164A is the #6,299 most-billed Medicaid procedure code, with $76K in payments across 2K claims from 2018–2024. The national median cost per claim is $40.00.
Total Paid
$76K
0.00% of all spending
Total Claims
2K
Providers
32
Avg Cost/Claim
$37
National Cost Distribution
How much do providers bill per claim for 0164A? Based on 29 providers billing this code nationally.
Median
$40.00
Average
$62.87
Std Dev
$114.06
Max
$654.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $36.33 and $45.87 per claim for this code.
90% bill between $33.08 and $62.82.
Top 1% bill above $489.64.
About This Procedure
HCPCS code 0164A was billed by 32 providers across 2K claims, totaling $76K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$40.00
Providers Billing
29
National Spending
$76K
Avg/Median Ratio
1.57×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 0164A
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1750443503 | $10K |
| 2 | Dhhs Phs Naihs Shiprock Hospital Shiprock, NM · General Acute Care Hospital | $8K |
| 3 | Richard Bone Chicago, IL · Internal Medicine, Gastroenterology | $7K |
| 4 | Aurora Medical Group, Inc. Milwaukee, WI · Internal Medicine | $6K |
| 5 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $5K |
| 6 | Clinicas De Salud Del Pueblo Inc Calexico, CA · Clinic/Center Federally Qualified Health Center (FQHC) | $5K |
| 7 | 1891806329 | $4K |
| 8 | 1336125046 | $4K |
| 9 | Permanente Medical Group Inc Richmond, CA · Internal Medicine | $3K |
| 10 | Brockton Neighborhood Health Center Brockton, MA · Clinic/Center, Federally Qualified Health Center (FQHC) | $3K |
| 11 | Presbyterian Healthcare Services Albuquerque, NM · Surgery | $3K |
| 12 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $2K |
| 13 | 1992144380 | $2K |
| 14 | 1336566892 | $2K |
| 15 | Permanente Medical Group Inc Stockton, CA · Anesthesiology | $1K |
| 16 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $1K |
| 17 | 1457980526 | $1K |
| 18 | 1225179641 | $1K |
| 19 | 1841373800 | $1K |
| 20 | 1124013230 | $890 |
Showing top 20 of 32 providers billing this code