#4471 of 11K

G0427

HCPCS Procedure Code

HCPCS code G0427 is the #4,471 most-billed Medicaid procedure code, with $567K in payments across 10K claims from 2018–2024. The national median cost per claim is $42.79. Costs vary widely — the 90th percentile is $197.08 per claim, 4.6× the median.

Total Paid

$567K

0.00% of all spending

Total Claims

10K

Providers

Avg Cost/Claim

$55

National Cost Distribution

How much do providers bill per claim for G0427? Based on 37 providers billing this code nationally.

Median

$42.79

Average

$70.23

Std Dev

$71.41

Max

$202.30

Percentile Distribution (Cost per Claim)

p10

$3.45

p25

$12.42

Median

$42.79

p75

$105.95

p90

$197.08

p95

$199.57

p99

$202.19

50% of providers bill between $12.42 and $105.95 per claim for this code.

90% bill between $3.45 and $197.08.

Top 1% bill above $202.19.

About This Procedure

HCPCS code G0427 was billed by 42 providers across 10K claims, totaling $567K in Medicaid payments from 2018–2024. This code was used for 7,999 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$42.79

Providers Billing

National Spending

$567K

Avg/Median Ratio

1.64×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for G0427

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1770763070	$185K	$196.00	4.6× median	Above 75th
2	1982799086	$120K	$197.52	4.6× median	Top 10%
3	1003965955	$65K	$198.97	4.6× median	Top 10%
4	1962431817	$39K	$105.95	2.5× median	Above Median
5	1568461788	$31K	$196.78	4.6× median	Above 75th
6	1013303080	$27K	$12.42	0.3× median	Below Median
7	1083036651	$17K	$36.93	0.9× median	Below Median
8	Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent	$14K	$82.53	1.9× median	Above Median
9	1457302010	$10K	$58.83	1.4× median	Above Median
10	1841603750	$7K	$190.77	4.5× median	Above 75th
11	1033154786	$7K	$33.12	0.8× median	Below Median
12	1174035612	$5K	$2.42	0.1× median	Below Median
13	1245266733	$5K	$31.62	0.7× median	Below Median
14	1396739165	$4K	$15.76	0.4× median	Below Median
15	1396003182	$4K	$66.19	1.5× median	Above Median
16	1790286193	$4K	$118.99	2.8× median	Above 75th
17	1043269798	$3K	$156.03	3.6× median	Above 75th
18	1619285442	$3K	$201.99	4.7× median	Top 10%
19	1225297807	$3K	$202.30	4.7× median	Top 1%
20	1144544040	$2K	$43.31	1.0× median	Above Median

Showing top 20 of 42 providers billing this code

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