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#2751 of 11K

G0475

HCPCS Procedure Code

HCPCS code G0475 is the #2,751 most-billed Medicaid procedure code, with $3.8M in payments across 385K claims from 2018–2024. The national median cost per claim is $11.30. Costs vary widely — the 90th percentile is $22.67 per claim, 2.0× the median.

Total Paid

$3.8M

0.00% of all spending

Total Claims

385K

Providers

244

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for G0475? Based on 200 providers billing this code nationally.

Median

$11.30

Average

$11.71

Std Dev

$9.61

Max

$54.23

Percentile Distribution (Cost per Claim)

p10
$0.42
p25
$3.01
Median
$11.30
p75
$18.23
p90
$22.67
p95
$27.00
p99
$40.86

50% of providers bill between $3.01 and $18.23 per claim for this code.

90% bill between $0.42 and $22.67.

Top 1% bill above $40.86.

About This Procedure

HCPCS code G0475 was billed by 244 providers across 385K claims, totaling $3.8M in Medicaid payments from 2018–2024. This code was used for 364K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.30

Providers Billing

200

National Spending

$3.8M

Avg/Median Ratio

1.04×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G0475

#ProviderTotal Paid
1Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$386K
21780658443$202K
31639111057$173K
4Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$166K
5Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$156K
6Mainegeneral Medical Center

Augusta, ME · General Acute Care Hospital

$152K
7San Juan Regional Medical Center, Inc.

Farmington, NM · Audiologist

$145K
8Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$123K
9Quest Diagnostics Llc Il

Wood Dale, IL · Clinical Medical Laboratory

$110K
101598717480$107K
111790706901$103K
121831132133$101K
13Spectrum Health Hospitals

Grand Rapids, MI · General Acute Care Hospital

$99K
141811524572$97K
151649299827$89K
161053356352$79K
171811069685$77K
181205882503$73K
19Laboratory Corporation Of America Holdings

Raritan, NJ · Clinical Medical Laboratory

$71K
201568446755$70K

Showing top 20 of 244 providers billing this code