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#5995 of 11K

G0494

HCPCS Procedure Code

HCPCS code G0494 is the #5,995 most-billed Medicaid procedure code, with $108K in payments across 57K claims from 2018–2024. The national median cost per claim is $15.39. Costs vary widely — the 90th percentile is $84.10 per claim, 5.5× the median.

Total Paid

$108K

0.00% of all spending

Total Claims

57K

Providers

81

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for G0494? Based on 15 providers billing this code nationally.

Median

$15.39

Average

$31.61

Std Dev

$42.00

Max

$134.54

Percentile Distribution (Cost per Claim)

p10
$0.50
p25
$1.44
Median
$15.39
p75
$57.86
p90
$84.10
p95
$103.97
p99
$128.43

50% of providers bill between $1.44 and $57.86 per claim for this code.

90% bill between $0.50 and $84.10.

Top 1% bill above $128.43.

About This Procedure

HCPCS code G0494 was billed by 81 providers across 57K claims, totaling $108K in Medicaid payments from 2018–2024. This code was used for 20K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$15.39

Providers Billing

15

National Spending

$108K

Avg/Median Ratio

2.05×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G0494

#ProviderTotal Paid
11215297478$20K
21598367583$17K
31801042866$15K
41033210844$13K
51245261858$12K
61871748210$11K
71912052838$10K
81073595245$4K
91669420337$3K
101710473673$1K
111912995127$1K
121225096886$876
131558366211$501
141912964818$131
151265421580$106
161669994471$0
171811226764$0
181366694010$0
191942608724$0
201609264597$0

Showing top 20 of 81 providers billing this code