D0604
HCPCS Procedure Code
HCPCS code D0604 is the #2,795 most-billed Medicaid procedure code, with $3.6M in payments across 98K claims from 2018–2024. The national median cost per claim is $7.95. Costs vary widely — the 90th percentile is $38.51 per claim, 4.8× the median.
Total Paid
$3.6M
0.00% of all spending
Total Claims
98K
Providers
14
Avg Cost/Claim
$37
National Cost Distribution
How much do providers bill per claim for D0604? Based on 9 providers billing this code nationally.
Median
$7.95
Average
$14.71
Std Dev
$14.30
Max
$39.47
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.04 and $17.45 per claim for this code.
90% bill between $3.94 and $38.51.
Top 1% bill above $39.38.
About This Procedure
HCPCS code D0604 was billed by 14 providers across 98K claims, totaling $3.6M in Medicaid payments from 2018–2024. This code was used for 51K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$7.95
Providers Billing
9
National Spending
$3.6M
Avg/Median Ratio
1.85×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for D0604
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1750365383 | $3.5M |
| 2 | 1184824203 | $22K |
| 3 | 1487774196 | $11K |
| 4 | 1326123670 | $9K |
| 5 | 1295904605 | $6K |
| 6 | 1346476025 | $2K |
| 7 | 1306954631 | $628 |
| 8 | 1609152354 | $111 |
| 9 | 1932238136 | $101 |
| 10 | 1306873500 | $0 |
| 11 | 1407030026 | $0 |
| 12 | Mountain Park Health Center Phoenix, AZ · Clinic/Center, Federally Qualified Health Center (FQHC) | $0 |
| 13 | 1558308825 | $0 |
| 14 | 1740387018 | $0 |
Showing top 14 of 14 providers billing this code