92604
HCPCS Procedure Code
HCPCS code 92604 is the #3,460 most-billed Medicaid procedure code, with $1.6M in payments across 18K claims from 2018–2024. The national median cost per claim is $62.19. Costs vary widely — the 90th percentile is $124.95 per claim, 2.0× the median.
Total Paid
$1.6M
0.00% of all spending
Total Claims
18K
Providers
56
Avg Cost/Claim
$90
National Cost Distribution
How much do providers bill per claim for 92604? Based on 55 providers billing this code nationally.
Median
$62.19
Average
$90.62
Std Dev
$162.43
Max
$1,196.45
Percentile Distribution (Cost per Claim)
50% of providers bill between $30.77 and $92.96 per claim for this code.
90% bill between $24.16 and $124.95.
Top 1% bill above $732.53.
About This Procedure
HCPCS code 92604 was billed by 56 providers across 18K claims, totaling $1.6M in Medicaid payments from 2018–2024. This code was used for 16K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$62.19
Providers Billing
55
National Spending
$1.6M
Avg/Median Ratio
1.46×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 92604
| # | Provider | Total Paid |
|---|---|---|
| 1 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $356K |
| 2 | University Hospital Newark, NJ · General Acute Care Hospital | $187K |
| 3 | 1114958584 | $171K |
| 4 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $161K |
| 5 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $133K |
| 6 | 1245251222 | $125K |
| 7 | 1780669200 | $88K |
| 8 | Children's Hospital Corporation Boston, MA · Clinic/Center | $63K |
| 9 | Hmh Hospitals Corporation Hackensack, NJ · Ambulance | $48K |
| 10 | Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children | $32K |
| 11 | University Hospitals Cleveland Medical Center Cleveland, OH · General Acute Care Hospital | $30K |
| 12 | 1235234535 | $25K |
| 13 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $18K |
| 14 | State University Of Iowa Iowa City, IA · General Acute Care Hospital | $17K |
| 15 | Seattle Children's Hospital Seattle, WA · Prosthetic/Orthotic Supplier | $16K |
| 16 | 1679660617 | $15K |
| 17 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $11K |
| 18 | 1437720414 | $11K |
| 19 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $11K |
| 20 | Spectrum Health Hospitals Grand Rapids, MI · General Acute Care Hospital | $11K |
Showing top 20 of 56 providers billing this code