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 101–150 of 263 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 81025 | Urine pregnancy test | 198 | $8.61 | $8.61 | $8.61 |
| 92134 | Cptrz oph dx img pst sgm rta | 198 | $27.89 | $23.12 | $36.25 |
| D2331 | Resin two surfaces-anterior | 194 | $99.44 | $84.80 | $106.00 |
| A4211 | Supp for self-adm injections | 183 | $10.50 | $8.10 | $12.46 |
| D1510 | Space maintainer fxd unilat | 171 | $215.56 | $162.86 | $256.50 |
| 99173 | Visual acuity screen | 170 | $2.67 | $0.00 | $18.95 |
| 74177 | Ct abd & pelvis w/contrast | 164 | $72.00 | $33.25 | $85.33 |
| 99215 | Office o/p est hi 40 min | 164 | $72.56 | $15.76 | $160.74 |
| D4355 | Full mouth debridement | 162 | $160.93 | $149.29 | $165.00 |
| G0151 | Hhcp-serv of pt,ea 15 min | 157 | $207.50 | $204.29 | $208.83 |
| A4554 | Disposable underpads | 156 | $2.32 | $1.88 | $2.90 |
| J2405 | Ondansetron hcl injection | 156 | $0.55 | $0.43 | $0.80 |
| 83605 | Assay of lactic acid | 155 | $100.07 | $31.95 | $167.09 |
| 92012 | Intrm oph exam est patient | 155 | $79.62 | $54.55 | $95.39 |
| A9575 | Inj gadoterate meglumi 0.1ml | 155 | $16.57 | $13.16 | $22.51 |
| 96372 | Ther/proph/diag inj sc/im | 153 | $14.64 | $7.66 | $15.80 |
| 00142 | Anes px on eye lens surgery | 152 | $77.33 | $10.15 | $106.78 |
| 96375 | Tx/pro/dx inj new drug addon | 150 | $46.53 | $24.34 | $218.34 |
| J2785 | Regadenoson injection | 149 | $28.85 | $23.56 | $38.95 |
| 71271 | Ct thorax lung cancer scr c- | 148 | $152.35 | $143.88 | $154.86 |
| 90677 | Pcv20 vaccine im | 148 | $24.41 | $0.00 | $154.43 |
| 99406 | Behav chng smoking 3-10 min | 148 | $0.00 | $0.00 | $0.00 |
| 81000 | Urinalysis nonauto w/scope | 145 | $4.02 | $4.02 | $4.02 |
| 90688 | Iiv4 vaccine splt 0.5 ml im | 140 | $9.10 | $0.00 | $20.88 |
| 93925 | Lower extremity study | 138 | $182.00 | $77.04 | $269.64 |
| G0296 | Visit to determ ldct elig | 137 | $27.91 | $26.99 | $28.58 |
| 99383 | Prev visit new age 5-11 | 133 | $124.75 | $123.49 | $125.40 |
| 90700 | Dtap vaccine < 7 yrs im | 132 | $0.00 | $0.00 | $0.00 |
| 99349 | Home/res vst est mod mdm 40 | 129 | $67.43 | $45.20 | $101.24 |
| A4206 | 1 cc sterile syringe&needle | 123 | $13.26 | $10.25 | $16.50 |
| 90658 | Iiv3 vaccine splt 0.5 ml im | 120 | $9.33 | $0.00 | $22.00 |
| A4217 | Sterile water/saline, 500 ml | 120 | $3.44 | $2.41 | $3.88 |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or | 120 | $338.70 | $161.74 | $541.93 |
| 93990 | Doppler flow testing | 117 | $55.12 | $29.64 | $144.15 |
| E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, | 117 | $54.42 | $30.15 | $68.32 |
| A4450 | Non-waterproof tape | 114 | $3.48 | $2.99 | $3.90 |
| 87804 | Influenza assay w/optic | 103 | $12.21 | $5.84 | $16.55 |
| 90863 | Pharmacologic mgmt w/psytx | 102 | $0.00 | $0.00 | $0.00 |
| 84443 | Assay thyroid stim hormone | 99 | $160.02 | $99.40 | $196.13 |
| 11042 | Dbrdmt subq tis 1st 20sqcm/< | 98 | $349.20 | $292.14 | $401.78 |
| 36902 | Intro cath dialysis circuit | 98 | $339.45 | $203.21 | $528.35 |
| 97110 | Therapeutic exercises | 96 | $75.84 | $71.68 | $80.00 |
| 85396 | Clotting assay whole blood | 93 | $88.93 | $81.68 | $102.10 |
| 87426 | Sarscov coronavirus ag ia | 92 | $141.52 | $131.15 | $155.00 |
| 01844 | Anes vasc shunt/shunt revj | 88 | $73.94 | $48.32 | $86.87 |
| 96374 | Ther/proph/diag inj iv push | 88 | $184.08 | $158.39 | $233.99 |
| J1100 | Dexamethasone sodium phos | 88 | $1.22 | $0.99 | $1.45 |
| 94760 | N-invas ear/pls oximetry 1 | 85 | $4.43 | $2.70 | $12.30 |
| 92136 | Ophthalmic biometry | 84 | $38.61 | $31.43 | $50.03 |
| 96415 | Chemo iv infusion addl hr | 83 | $50.47 | $45.67 | $61.41 |