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#6161 of 11K

G0454

HCPCS Procedure Code

HCPCS code G0454 is the #6,161 most-billed Medicaid procedure code, with $89K in payments across 5,994 claims from 2018–2024. The national median cost per claim is $0.78. Costs vary widely — the 90th percentile is $27.17 per claim, 34.8× the median.

Total Paid

$89K

0.00% of all spending

Total Claims

5,994

Providers

9

Avg Cost/Claim

$15

National Cost Distribution

How much do providers bill per claim for G0454? Based on 8 providers billing this code nationally.

Median

$0.78

Average

$11.12

Std Dev

$25.54

Max

$74.02

Percentile Distribution (Cost per Claim)

p10
$0.37
p25
$0.49
Median
$0.78
p75
$5.60
p90
$27.17
p95
$50.59
p99
$69.33

50% of providers bill between $0.49 and $5.60 per claim for this code.

90% bill between $0.37 and $27.17.

Top 1% bill above $69.33.

About This Procedure

HCPCS code G0454 was billed by 9 providers across 5,994 claims, totaling $89K in Medicaid payments from 2018–2024. This code was used for 4,713 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.78

Providers Billing

8

National Spending

$89K

Avg/Median Ratio

14.26×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G0454

#ProviderTotal Paid
11982705661$85K
21477609865$2K
31346543568$699
41699064113$660
51023332749$362
61104362169$246
71316293913$75
81942666466$72
91043460744$0

Showing top 9 of 9 providers billing this code