0490
HCPCS Procedure Code
HCPCS code 0490 is the #1,402 most-billed Medicaid procedure code, with $24.2M in payments across 164K claims from 2018–2024. The national median cost per claim is $58.18. Costs vary widely — the 90th percentile is $548.72 per claim, 9.4× the median.
Total Paid
$24.2M
0.00% of all spending
Total Claims
164K
Providers
77
Avg Cost/Claim
$148
National Cost Distribution
How much do providers bill per claim for 0490? Based on 54 providers billing this code nationally.
Median
$58.18
Average
$223.26
Std Dev
$309.55
Max
$1,255.19
Percentile Distribution (Cost per Claim)
50% of providers bill between $42.50 and $365.73 per claim for this code.
90% bill between $27.03 and $548.72.
Top 1% bill above $1,250.40.
About This Procedure
HCPCS code 0490 was billed by 77 providers across 164K claims, totaling $24.2M in Medicaid payments from 2018–2024. This code was used for 76K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$58.18
Providers Billing
54
National Spending
$24.2M
Avg/Median Ratio
3.84×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 0490
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1730124124 | $4.6M |
| 2 | 1235132481 | $3.7M |
| 3 | 1740318153 | $2.8M |
| 4 | 1639149255 | $1.6M |
| 5 | 1457643405 | $1.6M |
| 6 | 1407130727 | $1.4M |
| 7 | 1013980317 | $1.3M |
| 8 | 1396748547 | $1.0M |
| 9 | 1548354038 | $752K |
| 10 | 1649296807 | $640K |
| 11 | 1982709572 | $594K |
| 12 | 1346208642 | $528K |
| 13 | 1164974655 | $494K |
| 14 | 1013048461 | $478K |
| 15 | 1942617477 | $390K |
| 16 | 1255309803 | $349K |
| 17 | 1760440515 | $329K |
| 18 | 1497733661 | $245K |
| 19 | 1184699241 | $196K |
| 20 | 1326361460 | $135K |
Showing top 20 of 77 providers billing this code