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#5734 of 11K

0489

HCPCS Procedure Code

HCPCS code 0489 is the #5,734 most-billed Medicaid procedure code, with $147K in payments across 4,763 claims from 2018–2024. The national median cost per claim is $179.04. Costs vary widely — the 90th percentile is $1,297.55 per claim, 7.2× the median.

Total Paid

$147K

0.00% of all spending

Total Claims

4,763

Providers

26

Avg Cost/Claim

$31

National Cost Distribution

How much do providers bill per claim for 0489? Based on 6 providers billing this code nationally.

Median

$179.04

Average

$493.95

Std Dev

$758.26

Max

$1,969.87

Percentile Distribution (Cost per Claim)

p10
$5.25
p25
$42.63
Median
$179.04
p75
$523.63
p90
$1,297.55
p95
$1,633.71
p99
$1,902.64

50% of providers bill between $42.63 and $523.63 per claim for this code.

90% bill between $5.25 and $1,297.55.

Top 1% bill above $1,902.64.

About This Procedure

HCPCS code 0489 was billed by 26 providers across 4,763 claims, totaling $147K in Medicaid payments from 2018–2024. This code was used for 4,637 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$179.04

Providers Billing

6

National Spending

$147K

Avg/Median Ratio

2.76×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0489

#ProviderTotal Paid
1Grossmont Hospital Corporation

La Mesa, CA · General Acute Care Hospital

$94K
2Sharp Chula Vista Medical Center

Chula Vista, CA · General Acute Care Hospital

$28K
31639101116$14K
4Palomar Health

Escondido, CA · General Acute Care Hospital

$10K
51104906569$406
6County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$33
71194840421$0
81417089350$0
91750384079$0
101811129752$0
111487697215$0
121912108002$0
131114547114$0
141518940667$0
151720128556$0
161114081056$0
171750503017$0
18University Of California Irvine

Orange, CA · General Acute Care Hospital

$0
191477610640$0
201558575746$0

Showing top 20 of 26 providers billing this code