94004
HCPCS Procedure Code
HCPCS code 94004 is the #1,781 most-billed Medicaid procedure code, with $14.1M in payments across 159K claims from 2018–2024. The national median cost per claim is $22.42. Costs vary widely — the 90th percentile is $214.40 per claim, 9.6× the median.
Total Paid
$14.1M
0.00% of all spending
Total Claims
159K
Providers
44
Avg Cost/Claim
$89
National Cost Distribution
How much do providers bill per claim for 94004? Based on 43 providers billing this code nationally.
Median
$22.42
Average
$103.42
Std Dev
$243.00
Max
$1,428.09
Percentile Distribution (Cost per Claim)
50% of providers bill between $12.00 and $35.16 per claim for this code.
90% bill between $6.11 and $214.40.
Top 1% bill above $1,074.48.
About This Procedure
HCPCS code 94004 was billed by 44 providers across 159K claims, totaling $14.1M in Medicaid payments from 2018–2024. This code was used for 26K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$22.42
Providers Billing
43
National Spending
$14.1M
Avg/Median Ratio
4.61×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 94004
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1114174703 | $3.5M |
| 2 | 1821444209 | $2.9M |
| 3 | 1710978226 | $2.5M |
| 4 | 1558342329 | $1.4M |
| 5 | 1376080283 | $1.3M |
| 6 | 1952029126 | $462K |
| 7 | 1154741585 | $455K |
| 8 | 1215993233 | $336K |
| 9 | 1760436828 | $310K |
| 10 | 1043305832 | $157K |
| 11 | 1619565942 | $122K |
| 12 | 1205846789 | $95K |
| 13 | 1386864296 | $80K |
| 14 | 1932878741 | $80K |
| 15 | 1770689242 | $43K |
| 16 | 1356523666 | $36K |
| 17 | 1356468672 | $33K |
| 18 | 1639507221 | $30K |
| 19 | 1649265679 | $28K |
| 20 | 1730182635 | $22K |
Showing top 20 of 44 providers billing this code