#1503 of 11K

G0515

HCPCS Procedure Code

HCPCS code G0515 is the #1,503 most-billed Medicaid procedure code, with $20.9M in payments across 293K claims from 2018–2024. The national median cost per claim is $23.57. Costs vary widely — the 90th percentile is $123.35 per claim, 5.2× the median.

Total Paid

$20.9M

0.00% of all spending

Total Claims

293K

Providers

145

Avg Cost/Claim

$71

National Cost Distribution

How much do providers bill per claim for G0515? Based on 132 providers billing this code nationally.

Median

$23.57

Average

$47.18

Std Dev

$60.16

Max

$404.28

Percentile Distribution (Cost per Claim)

p10

$3.48

p25

$11.83

Median

$23.57

p75

$63.92

p90

$123.35

p95

$166.65

p99

$256.57

50% of providers bill between $11.83 and $63.92 per claim for this code.

90% bill between $3.48 and $123.35.

Top 1% bill above $256.57.

About This Procedure

HCPCS code G0515 was billed by 145 providers across 293K claims, totaling $20.9M in Medicaid payments from 2018–2024. This code was used for 61K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$23.57

Providers Billing

132

National Spending

$20.9M

Avg/Median Ratio

2.00×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G0515

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1740596568	$3.0M	$238.69	10.1× median	Top 10%
2	1679617955	$2.1M	$176.88	7.5× median	Top 10%
3	1629002936	$1.7M	$92.47	3.9× median	Above 75th
4	1629409867	$1.7M	$100.94	4.3× median	Above 75th
5	1033426739	$1.6M	$404.28	17.2× median	Top 1%
6	Goodwill Industries Of Northern New England Portland, ME · Clinic/Center Rehabilitation Comprehensive Outpatient Rehabilitation Facility (CORF)	$1.1M	$87.59	3.7× median	Above 75th
7	1023236445	$1.0M	$137.11	5.8× median	Top 10%
8	Universal Rehabilitation And Fitness, Inc. Livingston, NJ · Clinic/Center, Rehabilitation	$923K	$133.30	5.7× median	Top 10%
9	1205228343	$786K	$22.59	1.0× median	Below Median
10	1831441054	$671K	$71.24	3.0× median	Above 75th
11	1992764583	$588K	$24.76	1.1× median	Above Median
12	Bancroft A New Jersey Nonprofit Corporation Cherry Hill, NJ · Clinic/Center Rehabilitation	$577K	$108.10	4.6× median	Above 75th
13	1508928995	$426K	$192.87	8.2× median	Top 10%
14	1912215039	$364K	$85.49	3.6× median	Above 75th
15	1184061095	$356K	$139.27	5.9× median	Top 10%
16	1336384858	$339K	$201.40	8.5× median	Top 10%
17	1467604694	$338K	$53.54	2.3× median	Above Median
18	1417221649	$309K	$123.75	5.3× median	Top 10%
19	1598810970	$252K	$78.14	3.3× median	Above 75th
20	Garden State Rehab Services Elmwood Park, NJ · Clinic/Center Rehabilitation	$238K	$69.82	3.0× median	Above 75th

Showing top 20 of 145 providers billing this code

Related Procedures

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