#1993 of 11K

G0399

HCPCS Procedure Code

HCPCS code G0399 is the #1,993 most-billed Medicaid procedure code, with $10.4M in payments across 100K claims from 2018–2024. The national median cost per claim is $76.81. Costs vary widely — the 90th percentile is $172.46 per claim, 2.2× the median.

Total Paid

$10.4M

0.00% of all spending

Total Claims

100K

Providers

294

Avg Cost/Claim

$104

National Cost Distribution

How much do providers bill per claim for G0399? Based on 264 providers billing this code nationally.

Median

$76.81

Average

$101.85

Std Dev

$121.78

Max

$1,270.80

Percentile Distribution (Cost per Claim)

p10

$20.80

p25

$38.83

Median

$76.81

p75

$123.32

p90

$172.46

p95

$251.62

p99

$600.51

50% of providers bill between $38.83 and $123.32 per claim for this code.

90% bill between $20.80 and $172.46.

Top 1% bill above $600.51.

About This Procedure

HCPCS code G0399 was billed by 294 providers across 100K claims, totaling $10.4M in Medicaid payments from 2018–2024. This code was used for 86K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$76.81

Providers Billing

264

National Spending

$10.4M

Avg/Median Ratio

1.33×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G0399

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1417097593	$1.5M	$324.39	4.2× median	Top 10%
2	1518124155	$1.1M	$239.74	3.1× median	Top 10%
3	1124011440	$650K	$297.54	3.9× median	Top 10%
4	1295870871	$494K	$248.12	3.2× median	Top 10%
5	1467825182	$323K	$68.81	0.9× median	Below Median
6	1922264209	$307K	$143.82	1.9× median	Above 75th
7	Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine	$302K	$171.76	2.2× median	Above 75th
8	Berkshire Medical Center, Inc Pittsfield, MA · General Acute Care Hospital	$299K	$577.89	7.5× median	Top 10%
9	1225159932	$264K	$182.78	2.4× median	Top 10%
10	Temple University Hospital Inc Philadelphia, PA · General Acute Care Hospital	$219K	$128.20	1.7× median	Above 75th
11	1770581894	$210K	$90.28	1.2× median	Above Median
12	Saint Francis Hospital And Medical Center Hartford, CT · General Acute Care Hospital	$194K	$113.39	1.5× median	Above Median
13	1265431829	$183K	$92.26	1.2× median	Above Median
14	1750332771	$179K	$119.01	1.5× median	Above Median
15	1396920989	$164K	$158.77	2.1× median	Above 75th
16	1083614382	$120K	$126.78	1.7× median	Above 75th
17	1689624686	$116K	$75.99	1.0× median	Below Median
18	Englewood Hospital And Medical Center Englewood, NJ · General Acute Care Hospital	$115K	$252.24	3.3× median	Top 10%
19	1912995309	$108K	$141.13	1.8× median	Above 75th
20	1346497229	$106K	$77.78	1.0× median	Above Median

Showing top 20 of 294 providers billing this code

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