#5687 of 11K

G0443

HCPCS Procedure Code

HCPCS code G0443 is the #5,687 most-billed Medicaid procedure code, with $154K in payments across 42K claims from 2018–2024. The national median cost per claim is $5.25. Costs vary widely — the 90th percentile is $21.01 per claim, 4.0× the median.

Total Paid

$154K

0.00% of all spending

Total Claims

42K

Providers

139

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for G0443? Based on 70 providers billing this code nationally.

Median

$5.25

Average

$9.10

Std Dev

$8.07

Max

$25.11

Percentile Distribution (Cost per Claim)

p10

$0.53

p25

$1.86

Median

$5.25

p75

$16.50

p90

$21.01

p95

$23.95

p99

$24.86

50% of providers bill between $1.86 and $16.50 per claim for this code.

90% bill between $0.53 and $21.01.

Top 1% bill above $24.86.

About This Procedure

HCPCS code G0443 was billed by 139 providers across 42K claims, totaling $154K in Medicaid payments from 2018–2024. This code was used for 39K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.25

Providers Billing

National Spending

$154K

Avg/Median Ratio

1.73×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for G0443

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1689994329	$23K	$4.28	0.8× median	Below Median
2	1346506037	$22K	$4.26	0.8× median	Below Median
3	1235113044	$13K	$14.56	2.8× median	Above Median
4	1003913971	$13K	$19.81	3.8× median	Above 75th
5	1689682619	$11K	$7.57	1.4× median	Above Median
6	1699217174	$9K	$20.97	4.0× median	Above 75th
7	1619100377	$8K	$16.54	3.2× median	Above 75th
8	1558723791	$7K	$23.46	4.5× median	Top 10%
9	1578680310	$4K	$22.09	4.2× median	Top 10%
10	1235210956	$4K	$18.75	3.6× median	Above 75th
11	1770669715	$3K	$16.90	3.2× median	Above 75th
12	1568834216	$3K	$3.58	0.7× median	Below Median
13	1043603657	$3K	$15.31	2.9× median	Above Median
14	1861956971	$3K	$3.51	0.7× median	Below Median
15	1104994649	$2K	$2.66	0.5× median	Below Median
16	1740463546	$2K	$24.34	4.6× median	Top 10%
17	1346225927	$2K	$7.01	1.3× median	Above Median
18	1578631172	$2K	$7.17	1.4× median	Above Median
19	1114477817	$2K	$12.05	2.3× median	Above Median
20	1811068869	$1K	$17.80	3.4× median	Above 75th

Showing top 20 of 139 providers billing this code

Related Procedures

G0447$31.8M G0439Annual wellness visit, subsequent visit$31.5M G0444Annual depression screening, fifteen minutes$14.5M G0442$12.0M G0438Annual wellness visit, first visit$6.8M

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