#1642 of 11K

Z6004

HCPCS Procedure Code

HCPCS code Z6004 is the #1,642 most-billed Medicaid procedure code, with $17.1M in payments across 59K claims from 2018–2024. The national median cost per claim is $593.71. Costs vary widely — the 90th percentile is $1,557.07 per claim, 2.6× the median.

Total Paid

$17.1M

0.00% of all spending

Total Claims

59K

Providers

Avg Cost/Claim

$290

National Cost Distribution

How much do providers bill per claim for Z6004? Based on 34 providers billing this code nationally.

Median

$593.71

Average

$769.30

Std Dev

$661.40

Max

$2,160.92

Percentile Distribution (Cost per Claim)

p10

$126.68

p25

$127.14

Median

$593.71

p75

$1,401.07

p90

$1,557.07

p95

$1,586.99

p99

$1,978.30

50% of providers bill between $127.14 and $1,401.07 per claim for this code.

90% bill between $126.68 and $1,557.07.

Top 1% bill above $1,978.30.

About This Procedure

HCPCS code Z6004 was billed by 34 providers across 59K claims, totaling $17.1M in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$593.71

Providers Billing

National Spending

$17.1M

Avg/Median Ratio

1.30×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for Z6004

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1639132772	$3.3M	$1,607.53	2.7× median	Top 10%
2	1205835246	$2.2M	$1,575.93	2.7× median	Top 10%
3	Laurel Canyon Dialysis Llc Sun Valley, CA · Clinic/Center End-Stage Renal Disease (ESRD) Treatment	$1.7M	$167.47	0.3× median	Below Median
4	1730190331	$1.1M	$126.43	0.2× median	Below Median
5	1548231608	$984K	$250.61	0.4× median	Below Median
6	1124261854	$956K	$1,283.72	2.2× median	Above Median
7	1780676957	$938K	$127.13	0.2× median	Below Median
8	1003879081	$919K	$1,570.93	2.6× median	Top 10%
9	1871903385	$713K	$127.06	0.2× median	Below Median
10	1841201738	$540K	$128.15	0.2× median	Below Median
11	1336212059	$530K	$126.86	0.2× median	Below Median
12	1831411446	$401K	$1,524.72	2.6× median	Above 75th
13	1124118948	$381K	$115.79	0.2× median	Below Median
14	1841547460	$347K	$980.43	1.7× median	Above Median
15	1073587986	$284K	$1,493.35	2.5× median	Above 75th
16	1881686053	$259K	$127.12	0.2× median	Below Median
17	1659780120	$229K	$1,235.18	2.1× median	Above Median
18	1881639342	$212K	$542.22	0.9× median	Below Median
19	1083898001	$169K	$1,498.35	2.5× median	Above 75th
20	1841697414	$155K	$793.76	1.3× median	Above Median

Showing top 20 of 34 providers billing this code

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