#2427 of 11K

64400

HCPCS Procedure Code

HCPCS code 64400 is the #2,427 most-billed Medicaid procedure code, with $5.8M in payments across 61K claims from 2018–2024. The national median cost per claim is $114.91. Costs vary widely — the 90th percentile is $278.77 per claim, 2.4× the median.

Total Paid

$5.8M

0.00% of all spending

Total Claims

61K

Providers

160

Avg Cost/Claim

$97

National Cost Distribution

How much do providers bill per claim for 64400? Based on 154 providers billing this code nationally.

Median

$114.91

Average

$137.57

Std Dev

$139.20

Max

$1,237.14

Percentile Distribution (Cost per Claim)

p10

$24.65

p25

$40.08

Median

$114.91

p75

$179.83

p90

$278.77

p95

$327.07

p99

$538.08

50% of providers bill between $40.08 and $179.83 per claim for this code.

90% bill between $24.65 and $278.77.

Top 1% bill above $538.08.

About This Procedure

HCPCS code 64400 was billed by 160 providers across 61K claims, totaling $5.8M in Medicaid payments from 2018–2024. This code was used for 45K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$114.91

Providers Billing

154

National Spending

$5.8M

Avg/Median Ratio

1.20×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 64400

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1336319086	$398K	$112.84	1.0× median	Below Median
2	1013490259	$347K	$142.11	1.2× median	Above Median
3	1346411915	$339K	$39.05	0.3× median	Below Median
4	Hartford Hospital Hartford, CT · General Acute Care Hospital	$312K	$252.50	2.2× median	Above 75th
5	1457319485	$217K	$1,237.14	10.8× median	Top 1%
6	1407877137	$199K	$408.45	3.6× median	Top 10%
7	Samaritan Hospital Of Troy, New York Troy, NY	$197K	$391.69	3.4× median	Top 10%
8	Miami Valley Hospital Dayton, OH · General Acute Care Hospital	$183K	$263.66	2.3× median	Above 75th
9	Multicare Health System Tacoma, WA · Community/Behavioral Health	$165K	$276.53	2.4× median	Above 75th
10	1639111057	$159K	$149.39	1.3× median	Above Median
11	1578601969	$156K	$92.10	0.8× median	Below Median
12	Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital	$147K	$62.40	0.5× median	Below Median
13	1588656946	$133K	$126.00	1.1× median	Above Median
14	Spectrum Health Hospitals Grand Rapids, MI · General Acute Care Hospital	$133K	$136.19	1.2× median	Above Median
15	Swedish Health Services Seattle, WA · General Acute Care Hospital	$131K	$281.02	2.4× median	Top 10%
16	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$122K	$367.08	3.2× median	Top 10%
17	1669844908	$107K	$66.77	0.6× median	Below Median
18	Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment	$102K	$123.73	1.1× median	Above Median
19	Montefiore Medical Center Bronx, NY · Anesthesiology	$90K	$83.78	0.7× median	Below Median
20	1326098005	$90K	$103.83	0.9× median	Below Median

Showing top 20 of 160 providers billing this code

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