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#2597 of 11K

G0472

HCPCS Procedure Code

HCPCS code G0472 is the #2,597 most-billed Medicaid procedure code, with $4.7M in payments across 332K claims from 2018–2024. The national median cost per claim is $14.24. Costs vary widely — the 90th percentile is $34.62 per claim, 2.4× the median.

Total Paid

$4.7M

0.00% of all spending

Total Claims

332K

Providers

288

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for G0472? Based on 228 providers billing this code nationally.

Median

$14.24

Average

$15.41

Std Dev

$14.00

Max

$71.43

Percentile Distribution (Cost per Claim)

p10
$0.33
p25
$2.12
Median
$14.24
p75
$25.33
p90
$34.62
p95
$40.22
p99
$46.53

50% of providers bill between $2.12 and $25.33 per claim for this code.

90% bill between $0.33 and $34.62.

Top 1% bill above $46.53.

About This Procedure

HCPCS code G0472 was billed by 288 providers across 332K claims, totaling $4.7M in Medicaid payments from 2018–2024. This code was used for 315K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$14.24

Providers Billing

228

National Spending

$4.7M

Avg/Median Ratio

1.08×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G0472

#ProviderTotal Paid
1Spectrum Health Hospitals

Grand Rapids, MI · General Acute Care Hospital

$566K
21780658443$312K
3St Elizabeth Medical Center, Inc

Edgewood, KY · Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier

$235K
4Bethesda Hospital Inc

Cincinnati, OH · General Acute Care Hospital

$212K
51083249577$193K
61639111057$168K
71790706901$134K
81417901091$121K
9Henry Ford Health System

Detroit, MI · General Acute Care Hospital

$95K
101649299827$94K
11Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$87K
121073587937$87K
13William Beaumont Hospital

Royal Oak, MI · General Acute Care Hospital

$87K
141063836963$85K
15Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$81K
161932695525$80K
171831132133$79K
18Labone Of Ohio Inc

Cincinnati, OH · Clinical Medical Laboratory

$76K
191568446755$75K
201952307852$73K

Showing top 20 of 288 providers billing this code