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#6521 of 11K

G8997

HCPCS Procedure Code

HCPCS code G8997 is the #6,521 most-billed Medicaid procedure code, with $58K in payments across 12K claims from 2018–2024. The national median cost per claim is $3.58. Costs vary widely — the 90th percentile is $45.29 per claim, 12.7× the median.

Total Paid

$58K

0.00% of all spending

Total Claims

12K

Providers

144

Avg Cost/Claim

$5

National Cost Distribution

How much do providers bill per claim for G8997? Based on 48 providers billing this code nationally.

Median

$3.58

Average

$17.53

Std Dev

$28.65

Max

$136.76

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.00
Median
$3.58
p75
$23.68
p90
$45.29
p95
$72.76
p99
$122.34

50% of providers bill between $0.00 and $23.68 per claim for this code.

90% bill between $0.00 and $45.29.

Top 1% bill above $122.34.

About This Procedure

HCPCS code G8997 was billed by 144 providers across 12K claims, totaling $58K in Medicaid payments from 2018–2024. This code was used for 7,745 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3.58

Providers Billing

48

National Spending

$58K

Avg/Median Ratio

4.90×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G8997

#ProviderTotal Paid
11821093451$9K
21942204607$9K
31891782462$6K
41366446080$5K
51366433385$4K
61396732012$3K
71720089394$3K
81184629743$3K
91104814979$2K
101518961226$2K
111821289190$2K
121790846079$2K
131265692701$1K
14Orlando Health Inc.

Orlando, FL · General Acute Care Hospital

$1K
151255335857$972
161487681631$813
171053308775$668
181508863911$593
191427217637$553
201760479380$517

Showing top 20 of 144 providers billing this code