#3427 of 11K

G0493

HCPCS Procedure Code

HCPCS code G0493 is the #3,427 most-billed Medicaid procedure code, with $1.7M in payments across 212K claims from 2018–2024. The national median cost per claim is $40.89. Costs vary widely — the 90th percentile is $151.49 per claim, 3.7× the median.

Total Paid

$1.7M

0.00% of all spending

Total Claims

212K

Providers

296

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for G0493? Based on 67 providers billing this code nationally.

Median

$40.89

Average

$60.60

Std Dev

$64.22

Max

$304.77

Percentile Distribution (Cost per Claim)

p10

$0.48

p25

$9.20

Median

$40.89

p75

$90.48

p90

$151.49

p95

$182.48

p99

$253.89

50% of providers bill between $9.20 and $90.48 per claim for this code.

90% bill between $0.48 and $151.49.

Top 1% bill above $253.89.

About This Procedure

HCPCS code G0493 was billed by 296 providers across 212K claims, totaling $1.7M in Medicaid payments from 2018–2024. This code was used for 135K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$40.89

Providers Billing

National Spending

$1.7M

Avg/Median Ratio

1.48×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G0493

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1912052838	$361K	$142.34	3.5× median	Above 75th
2	1881670214	$268K	$86.89	2.1× median	Above Median
3	1639102163	$123K	$86.26	2.1× median	Above Median
4	1255401642	$79K	$304.77	7.5× median	Top 1%
5	1598810509	$78K	$122.68	3.0× median	Above 75th
6	1871748210	$76K	$8.72	0.2× median	Below Median
7	1881913424	$66K	$23.78	0.6× median	Below Median
8	New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine	$62K	$195.41	4.8× median	Top 10%
9	1962596775	$60K	$67.40	1.6× median	Above Median
10	1245385244	$60K	$58.14	1.4× median	Above Median
11	1184013369	$56K	$79.16	1.9× median	Above Median
12	Prime Home Health Services, Llc Brooklyn, NY · Home Health	$41K	$227.67	5.6× median	Top 10%
13	1700164506	$40K	$59.33	1.5× median	Above Median
14	1427037712	$39K	$55.49	1.4× median	Above Median
15	1073595245	$36K	$74.50	1.8× median	Above Median
16	International Health Solutions Inc Lawrence, MA · Home Health	$35K	$53.70	1.3× median	Above Median
17	1710032735	$34K	$140.03	3.4× median	Above 75th
18	1326399296	$33K	$30.91	0.8× median	Below Median
19	1124173059	$21K	$156.90	3.8× median	Top 10%
20	1407069578	$19K	$17.33	0.4× median	Below Median

Showing top 20 of 296 providers billing this code

Related Procedures

G0483Drug test, definitive, 22+ drug classes$1.15B G0500$6.3M G0499$6.2M G0498$1.6M G0495Skilled services of LPN in home health$1.1M

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