#2810 of 11K

76604

HCPCS Procedure Code

HCPCS code 76604 is the #2,810 most-billed Medicaid procedure code, with $3.5M in payments across 98K claims from 2018–2024. The national median cost per claim is $16.47. Costs vary widely — the 90th percentile is $72.20 per claim, 4.4× the median.

Total Paid

$3.5M

0.00% of all spending

Total Claims

98K

Providers

232

Avg Cost/Claim

$36

National Cost Distribution

How much do providers bill per claim for 76604? Based on 227 providers billing this code nationally.

Median

$16.47

Average

$28.73

Std Dev

$29.86

Max

$155.89

Percentile Distribution (Cost per Claim)

p10

$5.95

p25

$10.55

Median

$16.47

p75

$34.68

p90

$72.20

p95

$90.88

p99

$130.35

50% of providers bill between $10.55 and $34.68 per claim for this code.

90% bill between $5.95 and $72.20.

Top 1% bill above $130.35.

About This Procedure

HCPCS code 76604 was billed by 232 providers across 98K claims, totaling $3.5M in Medicaid payments from 2018–2024. This code was used for 89K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$16.47

Providers Billing

227

National Spending

$3.5M

Avg/Median Ratio

1.74×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 76604

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital	$882K	$38.10	2.3× median	Above 75th
2	Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital	$340K	$99.38	6.0× median	Top 10%
3	Alameda Health System Oakland, CA · General Acute Care Hospital	$209K	$73.16	4.4× median	Top 10%
4	University Of California Irvine Orange, CA · General Acute Care Hospital	$197K	$32.60	2.0× median	Above Median
5	The General Hospital Corporation Boston, MA · General Acute Care Hospital	$180K	$82.46	5.0× median	Top 10%
6	Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital	$147K	$74.24	4.5× median	Top 10%
7	Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital	$107K	$85.10	5.2× median	Top 10%
8	Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children	$102K	$130.64	7.9× median	Top 1%
9	1407806904	$70K	$28.32	1.7× median	Above Median
10	Boston Medical Center Corporation Boston, MA · General Acute Care Hospital	$57K	$71.00	4.3× median	Above 75th
11	University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program	$55K	$107.70	6.5× median	Top 10%
12	1740283324	$42K	$14.63	0.9× median	Below Median
13	Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital	$42K	$78.18	4.7× median	Top 10%
14	Arrowhead Regional Medical Center Colton, CA · General Acute Care Hospital	$36K	$43.27	2.6× median	Above 75th
15	1588663769	$36K	$24.50	1.5× median	Above Median
16	Riverside University Health Systems - Medical Center Moreno Valley, CA · General Acute Care Hospital	$35K	$34.37	2.1× median	Above Median
17	1073519443	$35K	$44.58	2.7× median	Above 75th
18	West Virginia University Medical Corporation Morgantown, WV · Anesthesiology	$34K	$20.33	1.2× median	Above Median
19	Montefiore Medical Center Bronx, NY · Anesthesiology	$34K	$24.66	1.5× median	Above Median
20	1093756025	$34K	$14.79	0.9× median	Below Median

Showing top 20 of 232 providers billing this code

← All procedures Top providers →