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#4084 of 11K

64520

HCPCS Procedure Code

HCPCS code 64520 is the #4,084 most-billed Medicaid procedure code, with $864K in payments across 7,138 claims from 2018–2024. The national median cost per claim is $81.58. Costs vary widely — the 90th percentile is $364.61 per claim, 4.5× the median.

Total Paid

$864K

0.00% of all spending

Total Claims

7,138

Providers

20

Avg Cost/Claim

$121

National Cost Distribution

How much do providers bill per claim for 64520? Based on 19 providers billing this code nationally.

Median

$81.58

Average

$144.73

Std Dev

$161.64

Max

$611.87

Percentile Distribution (Cost per Claim)

p10
$18.23
p25
$41.57
Median
$81.58
p75
$187.57
p90
$364.61
p95
$460.76
p99
$581.65

50% of providers bill between $41.57 and $187.57 per claim for this code.

90% bill between $18.23 and $364.61.

Top 1% bill above $581.65.

About This Procedure

HCPCS code 64520 was billed by 20 providers across 7,138 claims, totaling $864K in Medicaid payments from 2018–2024. This code was used for 5,528 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$81.58

Providers Billing

19

National Spending

$864K

Avg/Median Ratio

1.77×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 64520

#ProviderTotal Paid
11487102208$319K
21437309192$168K
31457319485$111K
41467418574$94K
51700808466$75K
61962403121$21K
71578643607$20K
81053361642$16K
9St. Barnabas Hospital

Bronx, NY · General Acute Care Hospital

$10K
101366651242$9K
111346878303$6K
121043366818$5K
131235300765$3K
141760411052$2K
151285283432$2K
161821282666$1K
171164664082$1K
181225005085$622
191568636009$502
201740583095$0

Showing top 20 of 20 providers billing this code

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