Guam Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Guam, based on 2024 claims data.
2024 Overview
Procedures
263
Total Claims
229.4K
Total Paid
$20.9M
Popular Services
Procedures
Showing 51–100 of 263 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 99285 | Emergency dept visit hi mdm | 697 | $148.20 | $84.02 | $334.51 |
| 96127 | Brief emotional/behav assmt | 649 | $4.45 | $0.00 | $5.07 |
| 92015 | Determine refractive state | 645 | $19.32 | $18.13 | $19.53 |
| J7050 | Normal saline solution infus | 645 | $2.79 | $0.94 | $7.27 |
| 80053 | Comprehen metabolic panel | 632 | $195.54 | $9.68 | $247.42 |
| D2161 | Amalgam 4 or > surfaces perm | 587 | $128.45 | $122.35 | $130.00 |
| 99392 | Prev visit est age 1-4 | 585 | $103.10 | $88.65 | $110.52 |
| Q9967 | Locm 300-399mg/ml iodine,1ml | 581 | $26.56 | $0.46 | $512.10 |
| G2211 | Complex e/m visit add on | 566 | $8.92 | $0.73 | $16.71 |
| 90960 | Esrd srv 4 visits p mo 20+ | 562 | $173.28 | $91.39 | $354.12 |
| D7210 | Rem imp tooth w mucoper flp | 549 | $165.38 | $148.20 | $301.60 |
| 80076 | Hepatic function panel | 548 | $24.60 | $16.02 | $30.03 |
| A0428 | Bls | 532 | $59.64 | $23.69 | $108.61 |
| 99222 | 1st hosp ip/obs moderate 55 | 531 | $106.17 | $52.40 | $131.00 |
| D2330 | Resin one surface-anterior | 514 | $83.51 | $78.70 | $85.00 |
| 77067 | Scr mammo bi incl cad | 480 | $140.58 | $137.62 | $142.12 |
| A0425 | Ground mileage | 476 | $11.05 | $3.42 | $21.91 |
| 99394 | Prev visit est age 12-17 | 459 | $115.74 | $64.64 | $120.04 |
| 77063 | Breast tomosynthesis bi | 439 | $55.46 | $54.33 | $56.10 |
| 76641 | Ultrasound breast complete | 437 | $78.06 | $65.03 | $92.99 |
| 99204 | Office o/p new mod 45 min | 427 | $152.00 | $98.11 | $174.41 |
| 92250 | Fundus photography w/i&r | 426 | $26.42 | $17.25 | $40.08 |
| 90472 | Immunization admin each add | 417 | $35.44 | $18.98 | $54.71 |
| A4253 | Blood glucose/reagent strips | 400 | $9.60 | $7.88 | $14.56 |
| 87811 | Sars-cov-2 covid19 w/optic | 396 | $32.18 | $16.78 | $41.38 |
| V2199 | Lens single vision not oth c | 390 | $148.03 | $138.46 | $150.00 |
| 84484 | Assay of troponin quant | 381 | $162.84 | $95.05 | $249.49 |
| 99223 | 1st hosp ip/obs high 75 | 375 | $132.22 | $89.37 | $174.14 |
| 70450 | Ct head/brain w/o dye | 366 | $77.07 | $6.13 | $1,235.53 |
| 99391 | Per pm reeval est pat infant | 359 | $95.55 | $74.49 | $104.09 |
| G0300 | Hhs/hospice of lpn ea 15 min | 347 | $157.43 | $127.01 | $223.06 |
| 90945 | Dialysis one evaluation | 345 | $29.76 | $29.76 | $29.76 |
| D2950 | Core build-up incl any pins | 334 | $156.00 | $148.20 | $187.20 |
| 96413 | Chemo iv infusion 1 hr | 319 | $304.79 | $102.33 | $962.33 |
| 85027 | Complete cbc automated | 310 | $36.51 | $30.88 | $44.39 |
| 76805 | Ob us >/= 14 wks sngl fetus | 306 | $142.67 | $128.90 | $149.58 |
| A4259 | Lancets per box | 290 | $1.42 | $1.42 | $1.42 |
| 77080 | Dxa bone density axial | 286 | $42.37 | $38.95 | $43.37 |
| 66984 | Xcapsl ctrc rmvl w/o ecp | 259 | $656.02 | $380.06 | $894.15 |
| 82962 | Glucose blood test | 250 | $5.17 | $3.28 | $38.25 |
| 99238 | Hosp ip/obs dschrg mgmt 30/< | 234 | $77.88 | $41.29 | $86.44 |
| 90474 | Immune admin oral/nasal addl | 225 | $12.27 | $11.50 | $12.38 |
| A9500 | Tc99m sestamibi | 225 | $278.82 | $222.90 | $356.63 |
| 78452 | Ht muscle image spect mult | 224 | $278.40 | $222.78 | $352.66 |
| 93016 | Cv stress test supvj only | 219 | $12.47 | $10.08 | $15.97 |
| 93017 | Cv stress test tracing only | 219 | $18.44 | $15.22 | $23.25 |
| 93018 | Cv stress test i&r only | 219 | $8.20 | $6.63 | $10.50 |
| 59409 | Obstetrical care | 218 | $758.89 | $715.48 | $770.52 |
| J1050 | Medroxyprogesterone acetate | 208 | $85.50 | $85.50 | $85.50 |
| 99239 | Hosp ip/obs dschrg mgmt >30 | 204 | $96.48 | $67.77 | $116.44 |