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#1313 of 11K

64494

HCPCS Procedure Code

HCPCS code 64494 is the #1,313 most-billed Medicaid procedure code, with $27.8M in payments across 613K claims from 2018–2024. The national median cost per claim is $34.70. Costs vary widely — the 90th percentile is $106.98 per claim, 3.1× the median.

Total Paid

$27.8M

0.00% of all spending

Total Claims

613K

Providers

1K

Avg Cost/Claim

$45

National Cost Distribution

How much do providers bill per claim for 64494? Based on 1K providers billing this code nationally.

Median

$34.70

Average

$53.64

Std Dev

$70.16

Max

$633.49

Percentile Distribution (Cost per Claim)

p10
$5.86
p25
$18.55
Median
$34.70
p75
$59.44
p90
$106.98
p95
$170.67
p99
$382.70

50% of providers bill between $18.55 and $59.44 per claim for this code.

90% bill between $5.86 and $106.98.

Top 1% bill above $382.70.

About This Procedure

HCPCS code 64494 was billed by 1K providers across 613K claims, totaling $27.8M in Medicaid payments from 2018–2024. This code was used for 438K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$34.70

Providers Billing

1K

National Spending

$27.8M

Avg/Median Ratio

1.55×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 64494

#ProviderTotal Paid
11154481984$792K
21225450588$772K
31225440969$665K
41518998764$582K
51154365062$531K
61306280177$510K
71962405878$478K
81407116361$449K
9Aurora Health Care Metro, Inc.

Milwaukee, WI · Internal Medicine, Hematology & Oncology

$380K
10University Of Kentucky

Lexington, KY · General Acute Care Hospital

$361K
111871650739$336K
121285007989$336K
131043272750$330K
141467418574$321K
15Carilion Medical Center

Roanoke, VA · General Acute Care Hospital

$294K
161447244256$291K
171750493979$291K
181558570648$272K
191427230788$260K
201902969439$236K

Showing top 20 of 1K providers billing this code