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#1866 of 11K

G0257

HCPCS Procedure Code

HCPCS code G0257 is the #1,866 most-billed Medicaid procedure code, with $12.5M in payments across 91K claims from 2018–2024. The national median cost per claim is $70.95. Costs vary widely — the 90th percentile is $285.46 per claim, 4.0× the median.

Total Paid

$12.5M

0.00% of all spending

Total Claims

91K

Providers

126

Avg Cost/Claim

$138

National Cost Distribution

How much do providers bill per claim for G0257? Based on 111 providers billing this code nationally.

Median

$70.95

Average

$109.29

Std Dev

$123.95

Max

$594.56

Percentile Distribution (Cost per Claim)

p10
$3.28
p25
$15.84
Median
$70.95
p75
$153.93
p90
$285.46
p95
$382.94
p99
$463.17

50% of providers bill between $15.84 and $153.93 per claim for this code.

90% bill between $3.28 and $285.46.

Top 1% bill above $463.17.

About This Procedure

HCPCS code G0257 was billed by 126 providers across 91K claims, totaling $12.5M in Medicaid payments from 2018–2024. This code was used for 33K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$70.95

Providers Billing

111

National Spending

$12.5M

Avg/Median Ratio

1.54×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for G0257

#ProviderTotal Paid
11992968150$2.6M
21881632818$1.7M
31982658407$1.6M
41144228446$1.1M
51386681468$834K
6Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$535K
71285662239$509K
81477599975$443K
91447206438$382K
10Medstar Washington Hospital Center

Washington, DC · General Acute Care Hospital

$372K
11Aurora Health Care Metro, Inc.

Milwaukee, WI · Internal Medicine, Hematology & Oncology

$301K
121326085424$138K
13Miami Valley Hospital

Dayton, OH · General Acute Care Hospital

$136K
141376571323$117K
151205900370$100K
16Banner - University Medical Center Phoenix

Phoenix, AZ · Clinic/Center, Sleep Disorder Diagnostic

$100K
17Hartford Hospital

Hartford, CT · General Acute Care Hospital

$94K
181891367629$91K
191295106870$82K
20Lee Memorial Health System

Ft Myers, FL · General Acute Care Hospital

$76K

Showing top 20 of 126 providers billing this code