#4310 of 11K

64999

HCPCS Procedure Code

HCPCS code 64999 is the #4,310 most-billed Medicaid procedure code, with $673K in payments across 12K claims from 2018–2024. The national median cost per claim is $64.48. Costs vary widely — the 90th percentile is $163.64 per claim, 2.5× the median.

Total Paid

$673K

0.00% of all spending

Total Claims

12K

Providers

Avg Cost/Claim

$58

National Cost Distribution

How much do providers bill per claim for 64999? Based on 39 providers billing this code nationally.

Median

$64.48

Average

$85.69

Std Dev

$83.52

Max

$357.78

Percentile Distribution (Cost per Claim)

p10

$12.76

p25

$33.47

Median

$64.48

p75

$116.22

p90

$163.64

p95

$291.97

p99

$346.83

50% of providers bill between $33.47 and $116.22 per claim for this code.

90% bill between $12.76 and $163.64.

Top 1% bill above $346.83.

About This Procedure

HCPCS code 64999 was billed by 48 providers across 12K claims, totaling $673K in Medicaid payments from 2018–2024. This code was used for 7,972 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$64.48

Providers Billing

National Spending

$673K

Avg/Median Ratio

1.33×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 64999

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1962405878	$132K	$73.28	1.1× median	Above Median
2	1801835731	$94K	$328.98	5.1× median	Top 10%
3	1952574642	$85K	$39.66	0.6× median	Below Median
4	1386187540	$83K	$39.44	0.6× median	Below Median
5	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$41K	$20.52	0.3× median	Below Median
6	1497797153	$33K	$357.78	5.5× median	Top 1%
7	1225016926	$33K	$127.37	2.0× median	Above 75th
8	1417690959	$24K	$61.18	0.9× median	Below Median
9	Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry	$18K	$161.36	2.5× median	Above 75th
10	Montefiore Medical Center Bronx, NY · Anesthesiology	$18K	$127.13	2.0× median	Above 75th
11	1871986372	$17K	$287.86	4.5× median	Top 10%
12	1538639166	$14K	$119.65	1.9× median	Above 75th
13	1558391763	$12K	$43.51	0.7× median	Below Median
14	1548208564	$11K	$91.18	1.4× median	Above Median
15	1760764849	$8K	$75.01	1.2× median	Above Median
16	1356968952	$7K	$42.04	0.7× median	Below Median
17	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$5K	$121.22	1.9× median	Above 75th
18	1417994872	$5K	$93.17	1.4× median	Above Median
19	Ahs Hospital Corp. Morristown, NJ · General Acute Care Hospital	$4K	$74.25	1.2× median	Above Median
20	1750751566	$4K	$61.82	1.0× median	Below Median

Showing top 20 of 48 providers billing this code

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