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#8219 of 11K

G0403

HCPCS Procedure Code

HCPCS code G0403 is the #8,219 most-billed Medicaid procedure code, with $5K in payments across 2,503 claims from 2018–2024. The national median cost per claim is $1.86. Costs vary widely — the 90th percentile is $5.67 per claim, 3.0× the median.

Total Paid

$5K

0.00% of all spending

Total Claims

2,503

Providers

25

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for G0403? Based on 17 providers billing this code nationally.

Median

$1.86

Average

$2.90

Std Dev

$3.42

Max

$14.55

Percentile Distribution (Cost per Claim)

p10
$0.82
p25
$0.91
Median
$1.86
p75
$3.31
p90
$5.67
p95
$7.98
p99
$13.24

50% of providers bill between $0.91 and $3.31 per claim for this code.

90% bill between $0.82 and $5.67.

Top 1% bill above $13.24.

About This Procedure

HCPCS code G0403 was billed by 25 providers across 2,503 claims, totaling $5K in Medicaid payments from 2018–2024. This code was used for 2,266 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1.86

Providers Billing

17

National Spending

$5K

Avg/Median Ratio

1.56×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for G0403

#ProviderTotal Paid
11124392584$2K
21225380603$648
31609869916$538
41881663904$386
51952681918$205
61144572553$181
71174833149$127
81295023547$110
91144236902$109
101992090310$70
111194842245$47
121932249596$42
131548538200$29
141770521270$26
151164604187$25
161952534927$17
171720456866$11
181861893844$0
191982855359$0
201457481053$0

Showing top 20 of 25 providers billing this code