G0463
Hospital outpatient clinic visit
Hospital outpatient clinic visit is the #44 most-billed Medicaid procedure code, with $4.45B in payments across 72.4M claims from 2018–2024. The national median cost per claim is $26.41. Costs vary widely — the 90th percentile is $88.79 per claim, 3.4× the median.
Total Paid
$4.45B
0.41% of all spending
Total Claims
72.4M
Providers
3K
Avg Cost/Claim
$61
National Cost Distribution
How much do providers bill per claim for G0463? Based on 3K providers billing this code nationally.
Median
$26.41
Average
$40.45
Std Dev
$48.51
Max
$654.31
Percentile Distribution (Cost per Claim)
50% of providers bill between $10.79 and $58.27 per claim for this code.
90% bill between $4.21 and $88.79.
Top 1% bill above $187.91.
About This Procedure
HCPCS code G0463 (Hospital outpatient clinic visit) was billed by 3K providers across 72.4M claims, totaling $4.45B in Medicaid payments from 2018–2024. This code was used for 58.0M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$26.41
Providers Billing
3K
National Spending
$4.45B
Avg/Median Ratio
1.53×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for G0463
| # | Provider | Total Paid |
|---|---|---|
| 1 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $270.0M |
| 2 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $233.9M |
| 3 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $120.6M |
| 4 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $115.8M |
| 5 | Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital | $105.1M |
| 6 | Holzer Hospital Foundation Gallipolis, OH · General Acute Care Hospital Rural | $74.7M |
| 7 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $72.3M |
| 8 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $56.9M |
| 9 | State University Of Iowa Iowa City, IA · General Acute Care Hospital | $54.9M |
| 10 | Mainegeneral Medical Center Augusta, ME · General Acute Care Hospital | $46.9M |
| 11 | Sage River Counseling Seattle, WA · Counselor Mental Health | $45.3M |
| 12 | Broadlawns Medical Center Des Moines, IA · General Acute Care Hospital | $44.9M |
| 13 | The Children's Mercy Hospital Kansas City, MO · General Acute Care Hospital Children | $44.6M |
| 14 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $43.6M |
| 15 | Henry Ford Health System Detroit, MI · General Acute Care Hospital | $42.1M |
| 16 | 1053357244 | $39.9M |
| 17 | Vanderbilt University Medical Center Nashville, TN · Psychiatric Unit | $39.7M |
| 18 | Southern Ohio Medical Center Portsmouth, OH · Clinical Medical Laboratory | $38.8M |
| 19 | Public Hospital District 1 Of King County Renton, WA · General Acute Care Hospital | $38.1M |
| 20 | 1700827896 | $36.5M |
Showing top 20 of 3K providers billing this code