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#3088 of 11K

D0364

HCPCS Procedure Code

HCPCS code D0364 is the #3,088 most-billed Medicaid procedure code, with $2.5M in payments across 35K claims from 2018–2024. The national median cost per claim is $124.97. Costs vary widely — the 90th percentile is $250.00 per claim, 2.0× the median.

Total Paid

$2.5M

0.00% of all spending

Total Claims

35K

Providers

93

Avg Cost/Claim

$73

National Cost Distribution

How much do providers bill per claim for D0364? Based on 53 providers billing this code nationally.

Median

$124.97

Average

$148.07

Std Dev

$163.93

Max

$1,099.41

Percentile Distribution (Cost per Claim)

p10
$5.23
p25
$47.47
Median
$124.97
p75
$200.00
p90
$250.00
p95
$299.84
p99
$725.89

50% of providers bill between $47.47 and $200.00 per claim for this code.

90% bill between $5.23 and $250.00.

Top 1% bill above $725.89.

About This Procedure

HCPCS code D0364 was billed by 93 providers across 35K claims, totaling $2.5M in Medicaid payments from 2018–2024. This code was used for 32K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$124.97

Providers Billing

53

National Spending

$2.5M

Avg/Median Ratio

1.18×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D0364

#ProviderTotal Paid
11649754482$530K
21942735519$400K
31275031486$167K
41346571791$153K
51609956234$93K
61609920313$86K
71578012027$78K
81619973070$77K
91700999729$74K
101962673871$71K
111962577395$64K
121932586856$55K
131235573486$54K
141144431768$48K
151710215843$47K
161801359237$45K
171932304029$40K
181194832675$40K
191508967704$38K
201144834375$38K

Showing top 20 of 93 providers billing this code