HCPCS G6004

Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: 6-10 mev

Retired codeConventional Radiation Treatment12 hospitals with prices

Description from CMS's HCPCS Level II code file.

This code is retired. Some hospitals still list it.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for HCPCS G6004 by hospital
HospitalMedicaid managed care rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$137 – $2025 plans——
Deaconess Medical CenterSpokaneFile dated 2026-08-27$125 – $1325 plans——
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01———
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01—$224$344
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$129 – $1405 plans——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$127 – $1375 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$127 – $1375 plans——
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$130 – $1405 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$124 – $1315 plans——
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01———
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$130 – $1405 plans——
Yakima Valley MemorialYakimaFile dated 2026-08-27$124 – $1445 plans——

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.