#2000 of 11K

G0260

HCPCS Procedure Code

HCPCS code G0260 is the #2,000 most-billed Medicaid procedure code, with $10.3M in payments across 51K claims from 2018–2024. The national median cost per claim is $169.32.

Total Paid

$10.3M

0.00% of all spending

Total Claims

51K

Providers

162

Avg Cost/Claim

$201

National Cost Distribution

How much do providers bill per claim for G0260? Based on 154 providers billing this code nationally.

Median

$169.32

Average

$177.26

Std Dev

$111.86

Max

$508.80

Percentile Distribution (Cost per Claim)

p10

$36.27

p25

$84.19

Median

$169.32

p75

$247.51

p90

$302.88

p95

$376.22

p99

$492.06

50% of providers bill between $84.19 and $247.51 per claim for this code.

90% bill between $36.27 and $302.88.

Top 1% bill above $492.06.

About This Procedure

HCPCS code G0260 was billed by 162 providers across 51K claims, totaling $10.3M in Medicaid payments from 2018–2024. This code was used for 33K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$169.32

Providers Billing

154

National Spending

$10.3M

Avg/Median Ratio

1.05×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G0260

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1083708226	$2.4M	$242.62	1.4× median	Above Median
2	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$964K	$426.09	2.5× median	Top 10%
3	1457820466	$612K	$222.56	1.3× median	Above Median
4	Stamford Hospital Stamford, CT · Hospitalist	$465K	$295.90	1.7× median	Above 75th
5	1154481984	$428K	$120.63	0.7× median	Below Median
6	1992022297	$345K	$245.86	1.5× median	Above Median
7	Norton Hospitals Inc Louisville, KY · General Acute Care Hospital	$267K	$285.11	1.7× median	Above 75th
8	1164734232	$258K	$172.75	1.0× median	Above Median
9	1316966518	$256K	$210.68	1.2× median	Above Median
10	1659392819	$229K	$236.20	1.4× median	Above Median
11	1164430567	$229K	$145.55	0.9× median	Below Median
12	1962402354	$182K	$167.61	1.0× median	Below Median
13	1285767822	$166K	$126.09	0.7× median	Below Median
14	Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital	$153K	$432.60	2.6× median	Top 10%
15	Ohio State University Hospitals Columbus, OH · General Acute Care Hospital	$152K	$315.65	1.9× median	Top 10%
16	1396174454	$139K	$205.75	1.2× median	Above Median
17	1528031226	$138K	$248.18	1.5× median	Above 75th
18	Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment	$129K	$253.54	1.5× median	Above 75th
19	1396065082	$129K	$213.45	1.3× median	Above Median
20	1851531248	$121K	$198.20	1.2× median	Above Median

Showing top 20 of 162 providers billing this code

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