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#2987 of 11K

G0469

HCPCS Procedure Code

HCPCS code G0469 is the #2,987 most-billed Medicaid procedure code, with $2.8M in payments across 57K claims from 2018–2024. The national median cost per claim is $70.42. Costs vary widely — the 90th percentile is $217.79 per claim, 3.1× the median.

Total Paid

$2.8M

0.00% of all spending

Total Claims

57K

Providers

84

Avg Cost/Claim

$49

National Cost Distribution

How much do providers bill per claim for G0469? Based on 79 providers billing this code nationally.

Median

$70.42

Average

$102.45

Std Dev

$107.11

Max

$640.00

Percentile Distribution (Cost per Claim)

p10
$16.25
p25
$46.80
Median
$70.42
p75
$126.00
p90
$217.79
p95
$244.42
p99
$529.66

50% of providers bill between $46.80 and $126.00 per claim for this code.

90% bill between $16.25 and $217.79.

Top 1% bill above $529.66.

About This Procedure

HCPCS code G0469 was billed by 84 providers across 57K claims, totaling $2.8M in Medicaid payments from 2018–2024. This code was used for 51K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$70.42

Providers Billing

79

National Spending

$2.8M

Avg/Median Ratio

1.45×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G0469

#ProviderTotal Paid
11811065576$551K
21518945278$416K
31023560331$304K
41497833271$198K
51598202913$171K
61265591812$142K
71497148407$109K
81326055450$107K
91689693343$99K
101366519431$91K
111700178167$73K
121366582090$57K
13Greenville Rancheria

Red Bluff, CA · Clinic/Center Community Health

$51K
141013952597$42K
151043501539$37K
161023008349$33K
171700801263$27K
181548663875$23K
191073711057$19K
201811171978$18K

Showing top 20 of 84 providers billing this code