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#3376 of 11K

G1004

HCPCS Procedure Code

HCPCS code G1004 is the #3,376 most-billed Medicaid procedure code, with $1.8M in payments across 3.4M claims from 2018–2024. The national median cost per claim is $0.01. Costs vary widely — the 90th percentile is $1.67 per claim, 167.0× the median.

Total Paid

$1.8M

0.00% of all spending

Total Claims

3.4M

Providers

1,432

Avg Cost/Claim

$1

National Cost Distribution

How much do providers bill per claim for G1004? Based on 454 providers billing this code nationally.

Median

$0.01

Average

$1.83

Std Dev

$10.99

Max

$165.18

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.00
Median
$0.01
p75
$0.23
p90
$1.67
p95
$5.23
p99
$42.18

50% of providers bill between $0.00 and $0.23 per claim for this code.

90% bill between $0.00 and $1.67.

Top 1% bill above $42.18.

About This Procedure

HCPCS code G1004 was billed by 1,432 providers across 3.4M claims, totaling $1.8M in Medicaid payments from 2018–2024. This code was used for 2.6M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.01

Providers Billing

454

National Spending

$1.8M

Avg/Median Ratio

183.00×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G1004

#ProviderTotal Paid
1Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$505K
2The Miriam Hospital

Providence, RI · General Acute Care Hospital

$475K
31629006457$86K
4Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$61K
51457346413$58K
61407887003$57K
71649220724$46K
8Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$45K
91699874248$35K
10Lee Memorial Health System

Ft Myers, FL · General Acute Care Hospital

$33K
11Ashland Hospital Corporation

Ashland, KY · Clinic/Center, Rural Health

$31K
121679660617$29K
131578527172$25K
14Owensboro Health Inc

Owensboro, KY · General Acute Care Hospital

$23K
151821186313$20K
161699286401$19K
171760446256$14K
18Pikeville Medical Center Inc

Pikeville, KY · General Acute Care Hospital

$14K
191235196510$10K
201780653618$10K

Showing top 20 of 1,432 providers billing this code