Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#3094 of 11K

G8978

HCPCS Procedure Code

HCPCS code G8978 is the #3,094 most-billed Medicaid procedure code, with $2.5M in payments across 343K claims from 2018–2024. The national median cost per claim is $5.17. Costs vary widely — the 90th percentile is $95.21 per claim, 18.4× the median.

Total Paid

$2.5M

0.00% of all spending

Total Claims

343K

Providers

1,598

Avg Cost/Claim

$7

National Cost Distribution

How much do providers bill per claim for G8978? Based on 583 providers billing this code nationally.

Median

$5.17

Average

$29.89

Std Dev

$51.82

Max

$401.36

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.27
Median
$5.17
p75
$37.50
p90
$95.21
p95
$133.59
p99
$220.65

50% of providers bill between $0.27 and $37.50 per claim for this code.

90% bill between $0.00 and $95.21.

Top 1% bill above $220.65.

About This Procedure

HCPCS code G8978 was billed by 1,598 providers across 343K claims, totaling $2.5M in Medicaid payments from 2018–2024. This code was used for 267K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.17

Providers Billing

583

National Spending

$2.5M

Avg/Median Ratio

5.78×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G8978

#ProviderTotal Paid
1Bronxcare Health System

Bronx, NY · General Acute Care Hospital

$320K
21942204607$90K
31376547091$56K
41558365270$50K
51366433385$49K
6Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$46K
71750385308$45K
8Adventist Health System-sunbelt, Inc

Orlando, FL · Ambulance, Land Transport

$37K
91366446080$36K
101063781839$35K
111275556128$34K
12Fi-broward Nursing Llc

Pompano Beach, FL · Skilled Nursing Facility

$34K
131215930995$34K
141497829774$32K
151063773075$31K
161083608293$30K
171942204771$28K
181649293622$27K
191255335857$26K
201548264096$25K

Showing top 20 of 1,598 providers billing this code