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#1509 of 11K

0064A

HCPCS Procedure Code

HCPCS code 0064A is the #1,509 most-billed Medicaid procedure code, with $20.8M in payments across 598K claims from 2018–2024. The national median cost per claim is $34.17.

Total Paid

$20.8M

0.00% of all spending

Total Claims

598K

Providers

4K

Avg Cost/Claim

$35

National Cost Distribution

How much do providers bill per claim for 0064A? Based on 3K providers billing this code nationally.

Median

$34.17

Average

$37.39

Std Dev

$57.21

Max

$861.25

Percentile Distribution (Cost per Claim)

p10
$6.67
p25
$21.82
Median
$34.17
p75
$40.00
p90
$46.68
p95
$66.18
p99
$398.86

50% of providers bill between $21.82 and $40.00 per claim for this code.

90% bill between $6.67 and $46.68.

Top 1% bill above $398.86.

About This Procedure

HCPCS code 0064A was billed by 4K providers across 598K claims, totaling $20.8M in Medicaid payments from 2018–2024. This code was used for 549K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$34.17

Providers Billing

3K

National Spending

$20.8M

Avg/Median Ratio

1.09×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0064A

#ProviderTotal Paid
1Dhhs Phs Naihs Shiprock Hospital

Shiprock, NM · General Acute Care Hospital

$1.4M
2Zuni Indian Hospital

Zuni, NM · General Acute Care Hospital

$715K
3Dhhs,phs,naihs, Gallup Indian Medical Center

Gallup, NM · General Acute Care Hospital

$477K
4Phs Indian Hospital

Red Lake, MN · General Acute Care Hospital

$414K
5Permanente Medical Group Inc

Stockton, CA · Anesthesiology

$412K
6County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$365K
7Kewa Pueblo Health Corporation

Santo Domingo Pueblo, NM · Clinic/Center

$259K
8Southern California Permanente Medical Group

San Diego, CA · Health Maintenance Organization

$236K
9Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$234K
10Chinatown True Care Medical Pllc

New York, NY · Family Medicine

$205K
11Southern California Permanente Medical Group

Bellflower, CA · Health Maintenance Organization

$184K
12Permanente Medical Group Inc

Richmond, CA · Internal Medicine

$184K
13Southern California Permanente Medical Group

Los Angeles, CA · Health Maintenance Organization

$176K
14State Of Indiana Auditor Of State

Indianapolis, IN · Public Health or Welfare

$168K
151760439921$152K
16Dhhs Phs Naihs Crownpoint Hospital

Crownpoint, NM · General Acute Care Hospital

$151K
17Mescalero Indian Hospital

Mescalero, NM · General Acute Care Hospital, Rural

$145K
18St Regis Mohawk Tribe

Akwesasne, NY · Substance Abuse Rehabilitation Facility

$143K
19Southern California Permanente Medical Group

Anaheim, CA · Health Maintenance Organization

$130K
20Southern California Permanente Medical Group

Panorama City, CA · Health Maintenance Organization

$127K

Showing top 20 of 4K providers billing this code