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#3517 of 11K

G0498

HCPCS Procedure Code

HCPCS code G0498 is the #3,517 most-billed Medicaid procedure code, with $1.6M in payments across 17K claims from 2018–2024. The national median cost per claim is $58.18. Costs vary widely — the 90th percentile is $182.53 per claim, 3.1× the median.

Total Paid

$1.6M

0.00% of all spending

Total Claims

17K

Providers

38

Avg Cost/Claim

$92

National Cost Distribution

How much do providers bill per claim for G0498? Based on 35 providers billing this code nationally.

Median

$58.18

Average

$96.60

Std Dev

$124.35

Max

$642.99

Percentile Distribution (Cost per Claim)

p10
$1.96
p25
$11.16
Median
$58.18
p75
$145.21
p90
$182.53
p95
$240.34
p99
$536.90

50% of providers bill between $11.16 and $145.21 per claim for this code.

90% bill between $1.96 and $182.53.

Top 1% bill above $536.90.

About This Procedure

HCPCS code G0498 was billed by 38 providers across 17K claims, totaling $1.6M in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$58.18

Providers Billing

35

National Spending

$1.6M

Avg/Median Ratio

1.66×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for G0498

#ProviderTotal Paid
1Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$381K
2Hartford Hospital

Hartford, CT · General Acute Care Hospital

$187K
3The Hospital Of Central Connecticut At New Britain General And Bradley

New Britain, CT · General Acute Care Hospital

$158K
4Dana-farber Cancer Institute, Inc.

Boston, MA · General Acute Care Hospital

$143K
51851361778$129K
6Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$101K
7City Of Hope National Medical Center

Duarte, CA · General Acute Care Hospital

$101K
8University Medical Center, Inc

Louisville, KY · Student in an Organized Health Care Education/Training Program

$95K
9Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$77K
10Svmc Holdings, Inc

Bridgeport, CT · General Acute Care Hospital

$41K
111174582050$35K
12Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$23K
131164493847$22K
14The General Hospital Corporation

Boston, MA · General Acute Care Hospital

$17K
15Mainehealth

Portland, ME · Emergency Medicine

$17K
161427007848$12K
171295023547$8K
181871886366$7K
191003991845$5K
20Our Lady Of The Lake Hospital Inc.

Baton Rouge, LA · General Acute Care Hospital

$5K

Showing top 20 of 38 providers billing this code