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#2712 of 11K

64491

HCPCS Procedure Code

HCPCS code 64491 is the #2,712 most-billed Medicaid procedure code, with $4.0M in payments across 75K claims from 2018–2024. The national median cost per claim is $40.21. Costs vary widely — the 90th percentile is $124.69 per claim, 3.1× the median.

Total Paid

$4.0M

0.00% of all spending

Total Claims

75K

Providers

263

Avg Cost/Claim

$54

National Cost Distribution

How much do providers bill per claim for 64491? Based on 234 providers billing this code nationally.

Median

$40.21

Average

$61.47

Std Dev

$77.52

Max

$494.59

Percentile Distribution (Cost per Claim)

p10
$8.09
p25
$26.33
Median
$40.21
p75
$64.53
p90
$124.69
p95
$192.32
p99
$472.52

50% of providers bill between $26.33 and $64.53 per claim for this code.

90% bill between $8.09 and $124.69.

Top 1% bill above $472.52.

About This Procedure

HCPCS code 64491 was billed by 263 providers across 75K claims, totaling $4.0M in Medicaid payments from 2018–2024. This code was used for 55K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$40.21

Providers Billing

234

National Spending

$4.0M

Avg/Median Ratio

1.53×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 64491

#ProviderTotal Paid
11154481984$379K
21407116361$260K
31639142706$190K
41932317740$167K
51467418574$160K
61891000550$157K
71962405878$142K
81871650739$124K
91225440969$91K
101740856285$86K
111043272750$83K
121427230788$79K
131821282666$75K
141609085810$74K
151750493979$68K
161447244256$62K
171457851578$62K
181538227897$61K
191164664082$59K
201942423579$53K

Showing top 20 of 263 providers billing this code