Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#7535 of 11K

G8938

HCPCS Procedure Code

HCPCS code G8938 is the #7,535 most-billed Medicaid procedure code, with $15K in payments across 69K claims from 2018–2024. The national median cost per claim is $0.25. Costs vary widely — the 90th percentile is $30.14 per claim, 120.6× the median.

Total Paid

$15K

0.00% of all spending

Total Claims

69K

Providers

144

Avg Cost/Claim

$0

National Cost Distribution

How much do providers bill per claim for G8938? Based on 8 providers billing this code nationally.

Median

$0.25

Average

$8.06

Std Dev

$14.72

Max

$35.50

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.00
Median
$0.25
p75
$7.41
p90
$30.14
p95
$32.82
p99
$34.96

50% of providers bill between $0.00 and $7.41 per claim for this code.

90% bill between $0.00 and $30.14.

Top 1% bill above $34.96.

About This Procedure

HCPCS code G8938 was billed by 144 providers across 69K claims, totaling $15K in Medicaid payments from 2018–2024. This code was used for 50K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.25

Providers Billing

8

National Spending

$15K

Avg/Median Ratio

32.24×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G8938

#ProviderTotal Paid
11528000221$11K
21225099658$3K
31659353068$473
41003834433$227
51619973518$155
61811984099$0
71154608263$0
81679608061$0
91649265109$0
101366596405$0
111114334125$0
121366920746$0
131902169329$0
141760420335$0
151508890625$0
161427247501$0
171104144914$0
181225237613$0
19St Lukes Roosevelt Hospital Center

New York, NY · Case Management

$0
201205213014$0

Showing top 20 of 144 providers billing this code