#1700 of 11K

G0381

HCPCS Procedure Code

HCPCS code G0381 is the #1,700 most-billed Medicaid procedure code, with $15.9M in payments across 200K claims from 2018–2024. The national median cost per claim is $59.47. Costs vary widely — the 90th percentile is $156.64 per claim, 2.6× the median.

Total Paid

$15.9M

0.00% of all spending

Total Claims

200K

Providers

Avg Cost/Claim

$79

National Cost Distribution

How much do providers bill per claim for G0381? Based on 83 providers billing this code nationally.

Median

$59.47

Average

$74.56

Std Dev

$54.59

Max

$239.22

Percentile Distribution (Cost per Claim)

p10

$16.79

p25

$31.63

Median

$59.47

p75

$97.31

p90

$156.64

p95

$192.50

p99

$221.72

50% of providers bill between $31.63 and $97.31 per claim for this code.

90% bill between $16.79 and $156.64.

Top 1% bill above $221.72.

About This Procedure

HCPCS code G0381 was billed by 86 providers across 200K claims, totaling $15.9M in Medicaid payments from 2018–2024. This code was used for 184K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$59.47

Providers Billing

National Spending

$15.9M

Avg/Median Ratio

1.25×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G0381

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Bridgeport Hospital Bridgeport, CT · General Acute Care Hospital	$3.3M	$92.13	1.5× median	Above Median
2	1336245828	$1.4M	$150.22	2.5× median	Above 75th
3	1891376810	$1.2M	$90.89	1.5× median	Above Median
4	Mainehealth Portland, ME · Emergency Medicine	$1.2M	$74.56	1.3× median	Above Median
5	1487760906	$1.1M	$76.47	1.3× median	Above Median
6	Lee Memorial Health System Ft Myers, FL · General Acute Care Hospital	$993K	$73.43	1.2× median	Above Median
7	1710348214	$944K	$207.84	3.5× median	Top 10%
8	1831132133	$633K	$48.07	0.8× median	Below Median
9	1023114634	$610K	$59.47	1.0× median	Above Median
10	1053373480	$530K	$103.16	1.7× median	Above 75th
11	1982658407	$464K	$59.07	1.0× median	Below Median
12	1629075734	$372K	$83.54	1.4× median	Above Median
13	Lawrence And Memorial Hospital, Inc. New London, CT · Internal Medicine	$350K	$86.30	1.5× median	Above Median
14	1154346161	$317K	$47.27	0.8× median	Below Median
15	Dignity Health San Bernardino, CA · General Acute Care Hospital	$214K	$52.44	0.9× median	Below Median
16	1316394638	$211K	$95.61	1.6× median	Above Median
17	1124083894	$196K	$57.14	1.0× median	Below Median
18	1285715144	$179K	$91.25	1.5× median	Above Median
19	1205283538	$170K	$99.90	1.7× median	Above 75th
20	1639111057	$160K	$47.21	0.8× median	Below Median

Showing top 20 of 86 providers billing this code

Related Procedures

G0378Hospital observation service, per hour$2.16B G0390$66.9M G0382$36.3M G0379Direct admission to hospital observation$30.8M G0383$22.5M

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