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#1693 of 11K

64643

HCPCS Procedure Code

HCPCS code 64643 is the #1,693 most-billed Medicaid procedure code, with $16.0M in payments across 140K claims from 2018–2024. The national median cost per claim is $58.21. Costs vary widely — the 90th percentile is $213.36 per claim, 3.7× the median.

Total Paid

$16.0M

0.00% of all spending

Total Claims

140K

Providers

272

Avg Cost/Claim

$114

National Cost Distribution

How much do providers bill per claim for 64643? Based on 258 providers billing this code nationally.

Median

$58.21

Average

$102.45

Std Dev

$154.53

Max

$1,293.16

Percentile Distribution (Cost per Claim)

p10
$14.97
p25
$29.58
Median
$58.21
p75
$99.86
p90
$213.36
p95
$376.83
p99
$815.44

50% of providers bill between $29.58 and $99.86 per claim for this code.

90% bill between $14.97 and $213.36.

Top 1% bill above $815.44.

About This Procedure

HCPCS code 64643 was billed by 272 providers across 140K claims, totaling $16.0M in Medicaid payments from 2018–2024. This code was used for 124K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$58.21

Providers Billing

258

National Spending

$16.0M

Avg/Median Ratio

1.76×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 64643

#ProviderTotal Paid
1Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$1.8M
2Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$909K
3Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$822K
4The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$817K
5University Of Wisconsin Hospitals And Clinics Authority

Madison, WI · General Acute Care Hospital

$777K
6Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$638K
7Children's Hospital Medical Center Of Akron

Akron, OH · General Acute Care Hospital Children

$554K
8Dayton Children's Hospital

Dayton, OH · General Acute Care Hospital, Children

$497K
9Carolinas Medical Center

Charlotte, NC · General Acute Care Hospital

$471K
10Froedtert Memorial Lutheran Hospital, Inc.

Milwaukee, WI · Clinic/Center, Radiology

$461K
11Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$401K
121669617197$343K
131508819228$338K
14Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$321K
151255354130$267K
16Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$251K
171306156138$248K
18Rector & Visitors Of The University Of Virginia

Charlottesville, VA · General Acute Care Hospital

$203K
19State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$190K
201982793139$175K

Showing top 20 of 272 providers billing this code