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#2660 of 11K

64415

HCPCS Procedure Code

HCPCS code 64415 is the #2,660 most-billed Medicaid procedure code, with $4.3M in payments across 43K claims from 2018–2024. The national median cost per claim is $41.73. Costs vary widely — the 90th percentile is $272.20 per claim, 6.5× the median.

Total Paid

$4.3M

0.00% of all spending

Total Claims

43K

Providers

201

Avg Cost/Claim

$101

National Cost Distribution

How much do providers bill per claim for 64415? Based on 183 providers billing this code nationally.

Median

$41.73

Average

$100.01

Std Dev

$128.26

Max

$746.37

Percentile Distribution (Cost per Claim)

p10
$10.35
p25
$23.89
Median
$41.73
p75
$127.33
p90
$272.20
p95
$381.34
p99
$550.22

50% of providers bill between $23.89 and $127.33 per claim for this code.

90% bill between $10.35 and $272.20.

Top 1% bill above $550.22.

About This Procedure

HCPCS code 64415 was billed by 201 providers across 43K claims, totaling $4.3M in Medicaid payments from 2018–2024. This code was used for 38K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$41.73

Providers Billing

183

National Spending

$4.3M

Avg/Median Ratio

2.40×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 64415

#ProviderTotal Paid
1Baystate Medical Center Inc

Springfield, MA · General Acute Care Hospital

$700K
2Ohio State University Hospitals

Columbus, OH · General Acute Care Hospital

$409K
3Ohiohealth Corporation

Columbus, OH · General Acute Care Hospital

$290K
41316939556$239K
5The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$224K
61558314427$223K
71831109560$101K
8University Of Kentucky

Lexington, KY · General Acute Care Hospital

$101K
9Pikeville Medical Center Inc

Pikeville, KY · General Acute Care Hospital

$97K
10Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$86K
11Upmc Presbyterian Shadyside

Pittsburgh, PA · Clinic/Center

$80K
121497797153$74K
13Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$73K
141528242906$64K
15Montefiore Medical Center

Bronx, NY · Anesthesiology

$56K
16Uofl Health-louisville Inc

Louisville, KY · Psychiatric Hospital

$54K
171225016926$52K
181952385221$47K
191972126209$45K
201407821796$42K

Showing top 20 of 201 providers billing this code