#5230 of 11K

64454

HCPCS Procedure Code

HCPCS code 64454 is the #5,230 most-billed Medicaid procedure code, with $254K in payments across 2K claims from 2018–2024. The national median cost per claim is $122.14. Costs vary widely — the 90th percentile is $375.87 per claim, 3.1× the median.

Total Paid

$254K

0.00% of all spending

Total Claims

Providers

Avg Cost/Claim

$110

National Cost Distribution

How much do providers bill per claim for 64454? Based on 18 providers billing this code nationally.

Median

$122.14

Average

$178.02

Std Dev

$171.83

Max

$599.28

Percentile Distribution (Cost per Claim)

p10

$34.52

p25

$44.29

Median

$122.14

p75

$262.69

p90

$375.87

p95

$541.01

p99

$587.63

50% of providers bill between $44.29 and $262.69 per claim for this code.

90% bill between $34.52 and $375.87.

Top 1% bill above $587.63.

About This Procedure

HCPCS code 64454 was billed by 19 providers across 2K claims, totaling $254K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$122.14

Providers Billing

National Spending

$254K

Avg/Median Ratio

1.46×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 64454

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1164734232	$93K	$170.96	1.4× median	Above Median
2	1861824559	$38K	$43.14	0.4× median	Below Median
3	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$32K	$280.03	2.3× median	Above 75th
4	District Hospital Partners L P Washington, DC · Nurse Practitioner, Family	$24K	$530.73	4.3× median	Top 10%
5	1437146743	$20K	$47.75	0.4× median	Below Median
6	Medstar Washington Hospital Center Washington, DC · General Acute Care Hospital	$19K	$599.28	4.9× median	Top 1%
7	University Of Rochester Rochester, NY · General Acute Care Hospital	$6K	$308.00	2.5× median	Above 75th
8	The Metrohealth System Cleveland, OH · General Acute Care Hospital	$5K	$210.68	1.7× median	Above Median
9	Ahava Medical And Rehabilitation Center, Llc Brooklyn, NY · Rehabilitation Practitioner	$4K	$309.50	2.5× median	Above 75th
10	1295840007	$3K	$97.46	0.8× median	Below Median
11	1366651242	$2K	$203.65	1.7× median	Above Median
12	1790126084	$2K	$146.81	1.2× median	Above Median
13	1427230788	$2K	$40.39	0.3× median	Below Median
14	1508285776	$1K	$70.06	0.6× median	Below Median
15	1083898605	$1K	$36.43	0.3× median	Below Median
16	1790206415	$825	$51.55	0.4× median	Below Median
17	1861418220	$511	$30.06	0.2× median	Below Median
18	1073652160	$447	$27.93	0.2× median	Below Median
19	1841619731	$0	$0.00	0.0× median	Below Median

Showing top 19 of 19 providers billing this code

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64450$12.3M 64447$2.8M 64445$2.5M 64451$262K 64455$103K

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