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#4160 of 11K

64421

HCPCS Procedure Code

HCPCS code 64421 is the #4,160 most-billed Medicaid procedure code, with $796K in payments across 12K claims from 2018–2024. The national median cost per claim is $41.44. Costs vary widely — the 90th percentile is $120.33 per claim, 2.9× the median.

Total Paid

$796K

0.00% of all spending

Total Claims

12K

Providers

16

Avg Cost/Claim

$67

National Cost Distribution

How much do providers bill per claim for 64421? Based on 16 providers billing this code nationally.

Median

$41.44

Average

$50.01

Std Dev

$51.21

Max

$167.30

Percentile Distribution (Cost per Claim)

p10
$3.54
p25
$9.06
Median
$41.44
p75
$68.48
p90
$120.33
p95
$139.54
p99
$161.75

50% of providers bill between $9.06 and $68.48 per claim for this code.

90% bill between $3.54 and $120.33.

Top 1% bill above $161.75.

About This Procedure

HCPCS code 64421 was billed by 16 providers across 12K claims, totaling $796K in Medicaid payments from 2018–2024. This code was used for 7K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$41.44

Providers Billing

16

National Spending

$796K

Avg/Median Ratio

1.21×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 64421

#ProviderTotal Paid
11639142706$408K
21942275698$116K
31528345295$102K
41801835731$60K
51932187507$46K
61992271811$28K
71518016823$15K
81962405878$10K
91497768170$6K
101730178799$1K
111225016926$706
121386695930$668
131669475570$373
141720543762$326
151144855131$227
161760518609$160

Showing top 16 of 16 providers billing this code