96004
HCPCS Procedure Code
HCPCS code 96004 is the #6,770 most-billed Medicaid procedure code, with $43K in payments across 1,567 claims from 2018–2024. The national median cost per claim is $51.11.
Total Paid
$43K
0.00% of all spending
Total Claims
1,567
Providers
15
Avg Cost/Claim
$28
National Cost Distribution
How much do providers bill per claim for 96004? Based on 13 providers billing this code nationally.
Median
$51.11
Average
$49.49
Std Dev
$28.43
Max
$93.25
Percentile Distribution (Cost per Claim)
50% of providers bill between $34.92 and $62.13 per claim for this code.
90% bill between $8.05 and $83.94.
Top 1% bill above $92.16.
About This Procedure
HCPCS code 96004 was billed by 15 providers across 1,567 claims, totaling $43K in Medicaid payments from 2018–2024. This code was used for 1,236 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$51.11
Providers Billing
13
National Spending
$43K
Avg/Median Ratio
0.97×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 96004
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1932372638 | $22K |
| 2 | 1275271462 | $5K |
| 3 | 1003392457 | $4K |
| 4 | 1033150818 | $3K |
| 5 | 1134566953 | $3K |
| 6 | 1578046918 | $1K |
| 7 | 1326305509 | $1K |
| 8 | 1659796332 | $995 |
| 9 | 1205278199 | $931 |
| 10 | 1194844357 | $834 |
| 11 | 1134561020 | $808 |
| 12 | 1922150044 | $794 |
| 13 | 1528030269 | $137 |
| 14 | Cook Children's Physician Network Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.) | $0 |
| 15 | 1902958028 | $0 |
Showing top 15 of 15 providers billing this code