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#4297 of 11K

G0496

HCPCS Procedure Code

HCPCS code G0496 is the #4,297 most-billed Medicaid procedure code, with $685K in payments across 366K claims from 2018–2024. The national median cost per claim is $26.77. Costs vary widely — the 90th percentile is $141.31 per claim, 5.3× the median.

Total Paid

$685K

0.00% of all spending

Total Claims

366K

Providers

246

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for G0496? Based on 27 providers billing this code nationally.

Median

$26.77

Average

$51.78

Std Dev

$66.35

Max

$238.81

Percentile Distribution (Cost per Claim)

p10
$1.86
p25
$6.40
Median
$26.77
p75
$65.40
p90
$141.31
p95
$207.94
p99
$234.85

50% of providers bill between $6.40 and $65.40 per claim for this code.

90% bill between $1.86 and $141.31.

Top 1% bill above $234.85.

About This Procedure

HCPCS code G0496 was billed by 246 providers across 366K claims, totaling $685K in Medicaid payments from 2018–2024. This code was used for 104K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$26.77

Providers Billing

27

National Spending

$685K

Avg/Median Ratio

1.93×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for G0496

#ProviderTotal Paid
11295182830$177K
21659577971$115K
31952646952$70K
41790786150$55K
51114182870$51K
61215297478$51K
71205186210$41K
81821301490$30K
91083644017$20K
101558366211$15K
111003068180$15K
121336618487$11K
131932162096$8K
141538686738$6K
151194022657$5K
161205141504$4K
171295041036$2K
181396900726$2K
191174950505$2K
201235194507$1K

Showing top 20 of 246 providers billing this code