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#3953 of 11K

G0407

HCPCS Procedure Code

HCPCS code G0407 is the #3,953 most-billed Medicaid procedure code, with $982K in payments across 88K claims from 2018–2024. The national median cost per claim is $8.73. Costs vary widely — the 90th percentile is $54.60 per claim, 6.3× the median.

Total Paid

$982K

0.00% of all spending

Total Claims

88K

Providers

145

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for G0407? Based on 126 providers billing this code nationally.

Median

$8.73

Average

$17.66

Std Dev

$20.79

Max

$73.73

Percentile Distribution (Cost per Claim)

p10
$1.08
p25
$3.12
Median
$8.73
p75
$22.98
p90
$54.60
p95
$69.54
p99
$72.94

50% of providers bill between $3.12 and $22.98 per claim for this code.

90% bill between $1.08 and $54.60.

Top 1% bill above $72.94.

About This Procedure

HCPCS code G0407 was billed by 145 providers across 88K claims, totaling $982K in Medicaid payments from 2018–2024. This code was used for 47K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$8.73

Providers Billing

126

National Spending

$982K

Avg/Median Ratio

2.02×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G0407

#ProviderTotal Paid
11225297807$181K
21770763070$178K
31982799086$136K
41518412121$56K
51114479730$56K
61851890321$53K
71073641254$48K
81619285442$30K
91629428974$21K
101952740359$21K
111083036651$17K
121588152649$10K
131588741292$10K
141992215446$10K
151174035612$9K
161417132614$8K
171033160825$7K
181629639729$7K
191245266733$7K
201235631888$5K

Showing top 20 of 145 providers billing this code