Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#5022 of 11K

G0423

HCPCS Procedure Code

HCPCS code G0423 is the #5,022 most-billed Medicaid procedure code, with $318K in payments across 7,667 claims from 2018–2024. The national median cost per claim is $48.11. Costs vary widely — the 90th percentile is $103.74 per claim, 2.2× the median.

Total Paid

$318K

0.00% of all spending

Total Claims

7,667

Providers

12

Avg Cost/Claim

$42

National Cost Distribution

How much do providers bill per claim for G0423? Based on 11 providers billing this code nationally.

Median

$48.11

Average

$63.05

Std Dev

$74.79

Max

$257.81

Percentile Distribution (Cost per Claim)

p10
$7.51
p25
$10.50
Median
$48.11
p75
$81.78
p90
$103.74
p95
$180.78
p99
$242.41

50% of providers bill between $10.50 and $81.78 per claim for this code.

90% bill between $7.51 and $103.74.

Top 1% bill above $242.41.

About This Procedure

HCPCS code G0423 was billed by 12 providers across 7,667 claims, totaling $318K in Medicaid payments from 2018–2024. This code was used for 1,581 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$48.11

Providers Billing

11

National Spending

$318K

Avg/Median Ratio

1.31×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G0423

#ProviderTotal Paid
1Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$229K
21720031701$23K
3Riverside University Health Systems - Medical Center

Moreno Valley, CA · General Acute Care Hospital

$20K
41972503142$17K
5Geisinger Clinic

Danville, PA · Surgery

$11K
61942518022$9K
7Froedtert Memorial Lutheran Hospital, Inc.

Milwaukee, WI · Clinic/Center, Radiology

$4K
81336109107$3K
91982689113$835
101972939643$300
111659387934$217
121790775229$0

Showing top 12 of 12 providers billing this code