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#2560 of 11K

G8431

HCPCS Procedure Code

HCPCS code G8431 is the #2,560 most-billed Medicaid procedure code, with $5.0M in payments across 1.6M claims from 2018–2024. The national median cost per claim is $2.37. Costs vary widely — the 90th percentile is $29.01 per claim, 12.2× the median.

Total Paid

$5.0M

0.00% of all spending

Total Claims

1.6M

Providers

2,717

Avg Cost/Claim

$3

National Cost Distribution

How much do providers bill per claim for G8431? Based on 946 providers billing this code nationally.

Median

$2.37

Average

$9.53

Std Dev

$12.28

Max

$70.15

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.11
Median
$2.37
p75
$16.13
p90
$29.01
p95
$30.98
p99
$44.25

50% of providers bill between $0.11 and $16.13 per claim for this code.

90% bill between $0.00 and $29.01.

Top 1% bill above $44.25.

About This Procedure

HCPCS code G8431 was billed by 2,717 providers across 1.6M claims, totaling $5.0M in Medicaid payments from 2018–2024. This code was used for 1.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$2.37

Providers Billing

946

National Spending

$5.0M

Avg/Median Ratio

4.02×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G8431

#ProviderTotal Paid
11225685332$393K
21588089718$279K
3Union Community Health Center Inc.

Bronx, NY · Clinic/Center

$165K
41588153126$162K
51417188871$156K
61932505146$109K
71295165645$94K
81912293374$85K
91508977414$79K
101912091018$78K
111649438433$71K
121205451606$68K
131891711289$67K
141598143778$65K
151427121375$65K
161164662052$61K
171154503399$60K
181447448733$54K
191336680495$48K
201508379017$46K

Showing top 20 of 2,717 providers billing this code