Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#5644 of 11K

64425

HCPCS Procedure Code

HCPCS code 64425 is the #5,644 most-billed Medicaid procedure code, with $163K in payments across 3K claims from 2018–2024. The national median cost per claim is $56.10.

Total Paid

$163K

0.00% of all spending

Total Claims

3K

Providers

9

Avg Cost/Claim

$56

National Cost Distribution

How much do providers bill per claim for 64425? Based on 8 providers billing this code nationally.

Median

$56.10

Average

$55.99

Std Dev

$23.29

Max

$105.12

Percentile Distribution (Cost per Claim)

p10
$34.33
p25
$38.60
Median
$56.10
p75
$61.37
p90
$76.12
p95
$90.62
p99
$102.22

50% of providers bill between $38.60 and $61.37 per claim for this code.

90% bill between $34.33 and $76.12.

Top 1% bill above $102.22.

About This Procedure

HCPCS code 64425 was billed by 9 providers across 3K claims, totaling $163K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$56.10

Providers Billing

8

National Spending

$163K

Avg/Median Ratio

1.00×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 64425

#ProviderTotal Paid
11942301494$121K
21932402195$16K
31689761942$13K
41932187507$10K
51578592663$1K
61003887118$930
7Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$745
81548208564$514
91518989193$0

Showing top 9 of 9 providers billing this code