Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#5202 of 11K

64451

HCPCS Procedure Code

HCPCS code 64451 is the #5,202 most-billed Medicaid procedure code, with $262K in payments across 2K claims from 2018–2024. The national median cost per claim is $88.72. Costs vary widely — the 90th percentile is $261.71 per claim, 2.9× the median.

Total Paid

$262K

0.00% of all spending

Total Claims

2K

Providers

20

Avg Cost/Claim

$118

National Cost Distribution

How much do providers bill per claim for 64451? Based on 20 providers billing this code nationally.

Median

$88.72

Average

$119.51

Std Dev

$83.33

Max

$291.46

Percentile Distribution (Cost per Claim)

p10
$36.11
p25
$72.08
Median
$88.72
p75
$150.89
p90
$261.71
p95
$277.68
p99
$288.71

50% of providers bill between $72.08 and $150.89 per claim for this code.

90% bill between $36.11 and $261.71.

Top 1% bill above $288.71.

About This Procedure

HCPCS code 64451 was billed by 20 providers across 2K claims, totaling $262K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$88.72

Providers Billing

20

National Spending

$262K

Avg/Median Ratio

1.35×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 64451

#ProviderTotal Paid
11508285776$57K
21790126084$33K
31710491253$31K
41548557317$24K
51649518564$20K
61285283432$20K
71841619731$16K
81578819850$16K
91811987084$14K
101205364981$10K
111043625221$4K
121609257773$3K
131063831303$3K
141780071167$3K
151699704254$2K
161558885749$2K
171447271713$1K
181588224802$1K
191740287374$589
201174112007$71

Showing top 20 of 20 providers billing this code