64642
HCPCS Procedure Code
HCPCS code 64642 is the #1,456 most-billed Medicaid procedure code, with $22.7M in payments across 160K claims from 2018–2024. The national median cost per claim is $81.85. Costs vary widely — the 90th percentile is $310.12 per claim, 3.8× the median.
Total Paid
$22.7M
0.00% of all spending
Total Claims
160K
Providers
273
Avg Cost/Claim
$141
National Cost Distribution
How much do providers bill per claim for 64642? Based on 268 providers billing this code nationally.
Median
$81.85
Average
$148.07
Std Dev
$250.38
Max
$2,733.12
Percentile Distribution (Cost per Claim)
50% of providers bill between $54.71 and $152.26 per claim for this code.
90% bill between $34.67 and $310.12.
Top 1% bill above $1,000.04.
About This Procedure
HCPCS code 64642 was billed by 273 providers across 160K claims, totaling $22.7M in Medicaid payments from 2018–2024. This code was used for 146K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$81.85
Providers Billing
268
National Spending
$22.7M
Avg/Median Ratio
1.81×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 64642
| # | Provider | Total Paid |
|---|---|---|
| 1 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $2.0M |
| 2 | 1114958584 | $1.8M |
| 3 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $890K |
| 4 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $701K |
| 5 | Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children | $555K |
| 6 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $544K |
| 7 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $518K |
| 8 | 1508819228 | $496K |
| 9 | Carolinas Medical Center Charlotte, NC · General Acute Care Hospital | $466K |
| 10 | University Of Wisconsin Hospitals And Clinics Authority Madison, WI · General Acute Care Hospital | $427K |
| 11 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $422K |
| 12 | Vhs Childrens Hospital Of Michigan Inc Detroit, MI · Clinic/Center, Ambulatory Surgical | $418K |
| 13 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $406K |
| 14 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $373K |
| 15 | 1306156138 | $359K |
| 16 | Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital | $358K |
| 17 | 1477549756 | $350K |
| 18 | 1669617197 | $344K |
| 19 | Children's Hospital New Orleans, LA · General Acute Care Hospital Children | $332K |
| 20 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $327K |
Showing top 20 of 273 providers billing this code