#4686 of 11K

G0296

HCPCS Procedure Code

HCPCS code G0296 is the #4,686 most-billed Medicaid procedure code, with $450K in payments across 21K claims from 2018–2024. The national median cost per claim is $12.12. Costs vary widely — the 90th percentile is $32.81 per claim, 2.7× the median.

Total Paid

$450K

0.00% of all spending

Total Claims

21K

Providers

117

Avg Cost/Claim

$22

National Cost Distribution

How much do providers bill per claim for G0296? Based on 98 providers billing this code nationally.

Median

$12.12

Average

$17.02

Std Dev

$19.00

Max

$123.45

Percentile Distribution (Cost per Claim)

p10

$1.55

p25

$5.13

Median

$12.12

p75

$21.37

p90

$32.81

p95

$53.46

p99

$84.70

50% of providers bill between $5.13 and $21.37 per claim for this code.

90% bill between $1.55 and $32.81.

Top 1% bill above $84.70.

About This Procedure

HCPCS code G0296 was billed by 117 providers across 21K claims, totaling $450K in Medicaid payments from 2018–2024. This code was used for 18K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.12

Providers Billing

National Spending

$450K

Avg/Median Ratio

1.40×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G0296

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$174K	$33.36	2.8× median	Top 10%
2	The Health And Hospital Corporation Of Marion County Indianapolis, IN · Psychiatric Unit	$46K	$61.86	5.1× median	Top 10%
3	Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital	$24K	$66.25	5.5× median	Top 10%
4	1396709317	$22K	$30.18	2.5× median	Above 75th
5	1154321545	$21K	$19.75	1.6× median	Above Median
6	1366433195	$17K	$51.97	4.3× median	Top 10%
7	Albert Einstein Medical Center Phila, PA · General Acute Care Hospital	$14K	$40.60	3.3× median	Top 10%
8	1790028025	$10K	$14.58	1.2× median	Above Median
9	1689653487	$10K	$13.08	1.1× median	Above Median
10	1447226584	$9K	$28.27	2.3× median	Above 75th
11	Montefiore Medical Center Bronx, NY · Anesthesiology	$9K	$13.22	1.1× median	Above Median
12	1437425360	$8K	$17.84	1.5× median	Above Median
13	1154306512	$7K	$19.35	1.6× median	Above Median
14	1356412712	$6K	$18.06	1.5× median	Above Median
15	North Shore-lij Medical Pc Great Neck, NY · Urology	$5K	$27.31	2.3× median	Above 75th
16	1013924372	$5K	$32.73	2.7× median	Above 75th
17	Lsu Health Sciences Center Shreveport Faculty Group Practice Shreveport, LA · Oral & Maxillofacial Surgery	$4K	$15.30	1.3× median	Above Median
18	1376767426	$4K	$27.79	2.3× median	Above 75th
19	1548557978	$4K	$21.09	1.7× median	Above Median
20	Mary Imogene Bassett Hospital Cooperstown, NY · General Acute Care Hospital, Rural	$4K	$123.45	10.2× median	Top 1%

Showing top 20 of 117 providers billing this code

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G0299Skilled nursing services, home health, per visit, RN$1.91B G0300Skilled nursing services, home health, per visit, LPN$1.39B G0297$4.6M G0306$1.5M G0295$779K

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