#3574 of 11K

64616

HCPCS Procedure Code

HCPCS code 64616 is the #3,574 most-billed Medicaid procedure code, with $1.5M in payments across 16K claims from 2018–2024. The national median cost per claim is $66.22. Costs vary widely — the 90th percentile is $242.50 per claim, 3.7× the median.

Total Paid

$1.5M

0.00% of all spending

Total Claims

16K

Providers

Avg Cost/Claim

$94

National Cost Distribution

How much do providers bill per claim for 64616? Based on 62 providers billing this code nationally.

Median

$66.22

Average

$103.24

Std Dev

$105.16

Max

$578.83

Percentile Distribution (Cost per Claim)

p10

$26.67

p25

$41.05

Median

$66.22

p75

$115.21

p90

$242.50

p95

$262.54

p99

$502.30

50% of providers bill between $41.05 and $115.21 per claim for this code.

90% bill between $26.67 and $242.50.

Top 1% bill above $502.30.

About This Procedure

HCPCS code 64616 was billed by 63 providers across 16K claims, totaling $1.5M in Medicaid payments from 2018–2024. This code was used for 14K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$66.22

Providers Billing

National Spending

$1.5M

Avg/Median Ratio

1.56×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 64616

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Froedtert Memorial Lutheran Hospital, Inc. Milwaukee, WI · Clinic/Center, Radiology	$175K	$91.82	1.4× median	Above Median
2	University Of Washington Seattle, WA · Clinic/Center, Dental	$143K	$245.70	3.7× median	Top 10%
3	1477549756	$128K	$205.52	3.1× median	Above 75th
4	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$123K	$262.61	4.0× median	Top 10%
5	1861742991	$99K	$94.54	1.4× median	Above Median
6	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$80K	$104.31	1.6× median	Above Median
7	University Of Wisconsin Hospitals And Clinics Authority Madison, WI · General Acute Care Hospital	$55K	$114.55	1.7× median	Above Median
8	1669588158	$51K	$136.38	2.1× median	Above 75th
9	1073606901	$47K	$213.71	3.2× median	Above 75th
10	1194958223	$45K	$62.16	0.9× median	Below Median
11	Riverside Hospital Inc Newport News, VA · Psychiatric Hospital	$43K	$453.37	6.8× median	Top 10%
12	1043212665	$35K	$93.31	1.4× median	Above Median
13	1508804105	$34K	$21.05	0.3× median	Below Median
14	1588654016	$33K	$79.65	1.2× median	Above Median
15	1083708226	$30K	$175.32	2.6× median	Above 75th
16	Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital	$30K	$252.38	3.8× median	Top 10%
17	1508036773	$24K	$77.05	1.2× median	Above Median
18	1639418858	$21K	$183.05	2.8× median	Above 75th
19	1740213446	$20K	$115.43	1.7× median	Above 75th
20	1710020623	$19K	$109.64	1.7× median	Above Median

Showing top 20 of 63 providers billing this code

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