#5455 of 11K

64435

HCPCS Procedure Code

HCPCS code 64435 is the #5,455 most-billed Medicaid procedure code, with $195K in payments across 4K claims from 2018–2024. The national median cost per claim is $37.59.

Total Paid

$195K

0.00% of all spending

Total Claims

Providers

Avg Cost/Claim

$43

National Cost Distribution

How much do providers bill per claim for 64435? Based on 25 providers billing this code nationally.

Median

$37.59

Average

$42.08

Std Dev

$45.26

Max

$236.65

Percentile Distribution (Cost per Claim)

p10

$7.00

p25

$20.31

Median

$37.59

p75

$48.98

p90

$63.10

p95

$79.28

p99

$199.72

50% of providers bill between $20.31 and $48.98 per claim for this code.

90% bill between $7.00 and $63.10.

Top 1% bill above $199.72.

About This Procedure

HCPCS code 64435 was billed by 30 providers across 4K claims, totaling $195K in Medicaid payments from 2018–2024. This code was used for 4K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$37.59

Providers Billing

National Spending

$195K

Avg/Median Ratio

1.12×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 64435

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1770635260	$46K	$47.30	1.3× median	Above Median
2	1629634985	$43K	$236.65	6.3× median	Top 1%
3	1831570860	$28K	$65.35	1.7× median	Top 10%
4	1417959701	$22K	$21.38	0.6× median	Below Median
5	1467689794	$9K	$48.98	1.3× median	Above Median
6	1558424473	$7K	$26.06	0.7× median	Below Median
7	1932269644	$6K	$39.86	1.1× median	Above Median
8	1821484171	$6K	$82.77	2.2× median	Top 10%
9	1508930561	$5K	$52.97	1.4× median	Above 75th
10	1184641664	$5K	$31.14	0.8× median	Below Median
11	1730370594	$5K	$20.06	0.5× median	Below Median
12	1093834533	$4K	$27.36	0.7× median	Below Median
13	1073505764	$4K	$50.45	1.3× median	Above 75th
14	1558703017	$2K	$20.31	0.5× median	Below Median
15	1902108541	$1K	$39.70	1.1× median	Above Median
16	1053420992	$956	$59.73	1.6× median	Above 75th
17	1356447387	$943	$30.42	0.8× median	Below Median
18	1386000529	$572	$40.88	1.1× median	Above Median
19	1659671600	$483	$40.26	1.1× median	Above Median
20	1003974064	$451	$37.59	1.0× median	Below Median

Showing top 20 of 30 providers billing this code

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