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#5115 of 11K

64430

HCPCS Procedure Code

HCPCS code 64430 is the #5,115 most-billed Medicaid procedure code, with $286K in payments across 1K claims from 2018–2024. The national median cost per claim is $57.64. Costs vary widely — the 90th percentile is $308.57 per claim, 5.4× the median.

Total Paid

$286K

0.00% of all spending

Total Claims

1K

Providers

10

Avg Cost/Claim

$202

National Cost Distribution

How much do providers bill per claim for 64430? Based on 8 providers billing this code nationally.

Median

$57.64

Average

$119.49

Std Dev

$123.01

Max

$314.77

Percentile Distribution (Cost per Claim)

p10
$28.80
p25
$43.66
Median
$57.64
p75
$174.85
p90
$308.57
p95
$311.67
p99
$314.15

50% of providers bill between $43.66 and $174.85 per claim for this code.

90% bill between $28.80 and $308.57.

Top 1% bill above $314.15.

About This Procedure

HCPCS code 64430 was billed by 10 providers across 1K claims, totaling $286K in Medicaid payments from 2018–2024. This code was used for 1K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$57.64

Providers Billing

8

National Spending

$286K

Avg/Median Ratio

2.07×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 64430

#ProviderTotal Paid
11386709871$237K
21649362740$34K
31366433195$5K
41932187507$4K
51346230968$4K
61255449963$628
7University Physicians Incorporated

Aurora, CO · Anesthesiology

$587
81245248947$475
9Dignity Health

Phoenix, AZ · Rehabilitation Unit

$0
10Children's Hospital

New Orleans, LA · General Acute Care Hospital Children

$0

Showing top 10 of 10 providers billing this code