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#8394 of 11K

Q0164

HCPCS Procedure Code

HCPCS code Q0164 is the #8,394 most-billed Medicaid procedure code, with $3K in payments across 16K claims from 2018–2024. The national median cost per claim is $0.26. Costs vary widely — the 90th percentile is $2.20 per claim, 8.5× the median.

Total Paid

$3K

0.00% of all spending

Total Claims

16K

Providers

31

Avg Cost/Claim

$0

National Cost Distribution

How much do providers bill per claim for Q0164? Based on 18 providers billing this code nationally.

Median

$0.26

Average

$2.13

Std Dev

$6.82

Max

$29.27

Percentile Distribution (Cost per Claim)

p10
$0.03
p25
$0.08
Median
$0.26
p75
$0.53
p90
$2.20
p95
$7.27
p99
$24.87

50% of providers bill between $0.08 and $0.53 per claim for this code.

90% bill between $0.03 and $2.20.

Top 1% bill above $24.87.

About This Procedure

HCPCS code Q0164 was billed by 31 providers across 16K claims, totaling $3K in Medicaid payments from 2018–2024. This code was used for 9,356 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.26

Providers Billing

18

National Spending

$3K

Avg/Median Ratio

8.19×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for Q0164

#ProviderTotal Paid
11780653618$1K
2Dana-farber Cancer Institute, Inc.

Boston, MA · General Acute Care Hospital

$676
3University Of Kentucky

Lexington, KY · General Acute Care Hospital

$436
4Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$309
5U Of R Neurology Department

Rochester, NY · Psychiatry & Neurology Neurology

$196
6County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$74
7Arthur G James Cancer Hospital And Research Institute

Columbus, OH · Special Hospital

$63
81548315401$62
9Alameda Health System

Oakland, CA · General Acute Care Hospital

$61
10University Of Rochester

Rochester, NY · General Acute Care Hospital

$54
11Ohio State University Hospitals

Columbus, OH · General Acute Care Hospital

$32
12University Medical Center, Inc

Louisville, KY · Student in an Organized Health Care Education/Training Program

$29
131902839673$24
14The Cooper Health System

Camden, NJ · General Acute Care Hospital

$16
15Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$15
161104875103$7
17Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$3
18University Of California Irvine

Orange, CA · General Acute Care Hospital

$1
19Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$0
201356307581$0

Showing top 20 of 31 providers billing this code