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#4334 of 11K

G0406

HCPCS Procedure Code

HCPCS code G0406 is the #4,334 most-billed Medicaid procedure code, with $655K in payments across 48K claims from 2018–2024. The national median cost per claim is $6.02. Costs vary widely — the 90th percentile is $35.29 per claim, 5.9× the median.

Total Paid

$655K

0.00% of all spending

Total Claims

48K

Providers

133

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for G0406? Based on 114 providers billing this code nationally.

Median

$6.02

Average

$13.47

Std Dev

$17.92

Max

$142.31

Percentile Distribution (Cost per Claim)

p10
$0.40
p25
$1.79
Median
$6.02
p75
$20.85
p90
$35.29
p95
$38.87
p99
$45.53

50% of providers bill between $1.79 and $20.85 per claim for this code.

90% bill between $0.40 and $35.29.

Top 1% bill above $45.53.

About This Procedure

HCPCS code G0406 was billed by 133 providers across 48K claims, totaling $655K in Medicaid payments from 2018–2024. This code was used for 23K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.02

Providers Billing

114

National Spending

$655K

Avg/Median Ratio

2.24×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G0406

#ProviderTotal Paid
11073641254$152K
21245473057$79K
31104069277$75K
41831399518$43K
51386008936$35K
61811171085$35K
71972002228$17K
81245222454$16K
91033421953$16K
101669575627$15K
111427373638$14K
121942394499$12K
131194358523$10K
141518386739$7K
151538397120$7K
161952740359$6K
17Americare Inc.

Brooklyn, NY · Home Health

$6K
181538254511$5K
191093191322$5K
201801189592$5K

Showing top 20 of 133 providers billing this code