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#6197 of 11K

G0459

HCPCS Procedure Code

HCPCS code G0459 is the #6,197 most-billed Medicaid procedure code, with $84K in payments across 9,241 claims from 2018–2024. The national median cost per claim is $4.39. Costs vary widely — the 90th percentile is $33.27 per claim, 7.6× the median.

Total Paid

$84K

0.00% of all spending

Total Claims

9,241

Providers

22

Avg Cost/Claim

$9

National Cost Distribution

How much do providers bill per claim for G0459? Based on 13 providers billing this code nationally.

Median

$4.39

Average

$12.11

Std Dev

$13.65

Max

$37.60

Percentile Distribution (Cost per Claim)

p10
$1.09
p25
$2.05
Median
$4.39
p75
$23.43
p90
$33.27
p95
$36.08
p99
$37.30

50% of providers bill between $2.05 and $23.43 per claim for this code.

90% bill between $1.09 and $33.27.

Top 1% bill above $37.30.

About This Procedure

HCPCS code G0459 was billed by 22 providers across 9,241 claims, totaling $84K in Medicaid payments from 2018–2024. This code was used for 7,619 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$4.39

Providers Billing

13

National Spending

$84K

Avg/Median Ratio

2.76×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G0459

#ProviderTotal Paid
11689943946$48K
21558553065$18K
31104277656$5K
41831628783$5K
51023036613$4K
61699793034$2K
71487087201$937
81548360993$493
91710985064$152
101922342195$128
111154372464$66
121073042800$52
131649397969$45
141033147426$0
151396989380$0
161649334921$0
171790230183$0
181417132614$0
191801929757$0
201669422846$0

Showing top 20 of 22 providers billing this code