#3585 of 11K

G0476

HCPCS Procedure Code

HCPCS code G0476 is the #3,585 most-billed Medicaid procedure code, with $1.5M in payments across 98K claims from 2018–2024. The national median cost per claim is $13.94. Costs vary widely — the 90th percentile is $38.36 per claim, 2.8× the median.

Total Paid

$1.5M

0.00% of all spending

Total Claims

98K

Providers

164

Avg Cost/Claim

$15

National Cost Distribution

How much do providers bill per claim for G0476? Based on 107 providers billing this code nationally.

Median

$13.94

Average

$16.80

Std Dev

$15.08

Max

$54.61

Percentile Distribution (Cost per Claim)

p10

$0.29

p25

$2.23

Median

$13.94

p75

$27.72

p90

$38.36

p95

$44.59

p99

$50.33

50% of providers bill between $2.23 and $27.72 per claim for this code.

90% bill between $0.29 and $38.36.

Top 1% bill above $50.33.

About This Procedure

HCPCS code G0476 was billed by 164 providers across 98K claims, totaling $1.5M in Medicaid payments from 2018–2024. This code was used for 88K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.94

Providers Billing

107

National Spending

$1.5M

Avg/Median Ratio

1.21×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G0476

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	The Metrohealth System Cleveland, OH · General Acute Care Hospital	$267K	$9.09	0.7× median	Below Median
2	Mayo Collaborative Services, Inc Rochester, MN · Clinical Medical Laboratory	$136K	$30.76	2.2× median	Above 75th
3	Ohio State University Hospitals Columbus, OH · General Acute Care Hospital	$131K	$27.57	2.0× median	Above Median
4	1780633289	$105K	$28.37	2.0× median	Above 75th
5	Health Network Laboratories, Llc Allentown, PA · Clinical Medical Laboratory	$99K	$37.18	2.7× median	Above 75th
6	Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory	$87K	$9.17	0.7× median	Below Median
7	San Juan Regional Medical Center, Inc. Farmington, NM · Audiologist	$70K	$38.76	2.8× median	Top 10%
8	1427147883	$56K	$30.59	2.2× median	Above 75th
9	The Milton S Hershey Medical Center Hershey, PA · General Acute Care Hospital	$41K	$33.58	2.4× median	Above 75th
10	1043293608	$40K	$20.75	1.5× median	Above Median
11	1619923919	$40K	$20.16	1.4× median	Above Median
12	Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital	$40K	$36.26	2.6× median	Above 75th
13	1902841414	$39K	$19.71	1.4× median	Above Median
14	1285667493	$32K	$47.48	3.4× median	Top 10%
15	1063422053	$26K	$39.32	2.8× median	Top 10%
16	1073587937	$23K	$31.17	2.2× median	Above 75th
17	1699734665	$19K	$24.55	1.8× median	Above Median
18	1407949191	$15K	$19.75	1.4× median	Above Median
19	1730106162	$14K	$21.04	1.5× median	Above Median
20	1568577724	$13K	$39.28	2.8× median	Top 10%

Showing top 20 of 164 providers billing this code

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