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#7530 of 11K

G8397

HCPCS Procedure Code

HCPCS code G8397 is the #7,530 most-billed Medicaid procedure code, with $15K in payments across 99K claims from 2018–2024. The national median cost per claim is $0.03. Costs vary widely — the 90th percentile is $5.98 per claim, 199.3× the median.

Total Paid

$15K

0.00% of all spending

Total Claims

99K

Providers

181

Avg Cost/Claim

$0

National Cost Distribution

How much do providers bill per claim for G8397? Based on 14 providers billing this code nationally.

Median

$0.03

Average

$6.25

Std Dev

$20.11

Max

$75.75

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.00
Median
$0.03
p75
$1.04
p90
$5.98
p95
$31.68
p99
$66.93

50% of providers bill between $0.00 and $1.04 per claim for this code.

90% bill between $0.00 and $5.98.

Top 1% bill above $66.93.

About This Procedure

HCPCS code G8397 was billed by 181 providers across 99K claims, totaling $15K in Medicaid payments from 2018–2024. This code was used for 86K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.03

Providers Billing

14

National Spending

$15K

Avg/Median Ratio

208.33×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G8397

#ProviderTotal Paid
11902004427$11K
21750356754$3K
3Premier Eye Care Of Florida Llc

Coral Gables, FL · Exclusive Provider Organization

$394
41588109821$378
51114012689$212
61528569233$125
71861442022$74
81154315992$18
91255699658$12
101649563636$6
111487182580$5
121285644500$0
131053359489$0
141689604316$0
151588794200$0
161629023460$0
171952419053$0
181881897429$0
191871783308$0
201326248808$0

Showing top 20 of 181 providers billing this code