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#1256 of 11K

G0379

Direct admission to hospital observation

Direct admission to hospital observation is the #1,256 most-billed Medicaid procedure code, with $30.8M in payments across 196K claims from 2018–2024. The national median cost per claim is $48.25. Costs vary widely — the 90th percentile is $541.22 per claim, 11.2× the median.

Total Paid

$30.8M

0.00% of all spending

Total Claims

196K

Providers

313

Avg Cost/Claim

$157

National Cost Distribution

How much do providers bill per claim for G0379? Based on 270 providers billing this code nationally.

Median

$48.25

Average

$183.31

Std Dev

$363.75

Max

$2,497.89

Percentile Distribution (Cost per Claim)

p10
$2.81
p25
$11.57
Median
$48.25
p75
$149.40
p90
$541.22
p95
$788.19
p99
$2,101.14

50% of providers bill between $11.57 and $149.40 per claim for this code.

90% bill between $2.81 and $541.22.

Top 1% bill above $2,101.14.

About This Procedure

HCPCS code G0379 (Direct admission to hospital observation) was billed by 313 providers across 196K claims, totaling $30.8M in Medicaid payments from 2018–2024. This code was used for 160K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$48.25

Providers Billing

270

National Spending

$30.8M

Avg/Median Ratio

3.80×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G0379

#ProviderTotal Paid
1Connecticut Children's Medical Center

Hartford, CT · General Acute Care Hospital, Children

$4.5M
2Jersey City Medical Center

Jersey City, NJ · General Acute Care Hospital

$2.3M
3Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$1.9M
41770581894$1.5M
5Spectrum Health Hospitals

Grand Rapids, MI · General Acute Care Hospital

$1.5M
61316394638$1.4M
71831116441$1.1M
81689676835$1.1M
9Vhs Childrens Hospital Of Michigan Inc

Detroit, MI · Clinic/Center, Ambulatory Surgical

$1.1M
101043293608$848K
11Inova Health Care Services

Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder

$808K
12Svmc Holdings, Inc

Bridgeport, CT · General Acute Care Hospital

$792K
131902841414$650K
141053301127$603K
151255684460$534K
16State Of Connecticut

Farmington, CT · Counselor, Professional

$465K
171083759633$412K
18Newark Beth Israel Medical Center Inc

Newark, NJ · General Acute Care Hospital

$375K
191285253252$349K
20Novant Health New Hanover Regional Medical Center Llc

Wilmington, NC · Psychiatric Unit

$292K

Showing top 20 of 313 providers billing this code