HCPCS G0480

Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (CMS descriptor)

Other services Work RVU per service none (2024 fee schedule; adds 0 work RVUs)

1,595
89th percentile among 6,471 codes billed · 2024
$68M
97th percentile among 6,471 codes billed · 2024
616K
94th percentile among 6,471 codes billed · 2024
71
79th percentile among 6,471 codes billed · 2024
1,264
88th percentile among 6,471 codes billed · 2024
-3.2%
Medicare payment on the code vs 2023; billers +0.3% · 2024

Trend

Medicare payment on the code

$0$50M2020: $78M paid20202021: $77M paid20212022: $73M paid20222023: $70M paid20232024: $68M paid2024$68M$0$50M2020: $78M paid20202021: $77M paid20212022: $73M paid20222023: $70M paid20232024: $68M paid2024$68M$0$50M2020: $78M paid20202021: $77M paid20212022: $73M paid20222023: $70M paid20232024: $68M paid2024$68M$0$50M2020: $78M paid20202021: $77M paid20212022: $73M paid20222023: $70M paid20232024: $68M paid2024$68M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

01,0002020: 1,409 providers20202021: 1,394 providers20212022: 1,416 providers20222023: 1,590 providers20232024: 1,595 providers20241,59501,0002020: 1,409 providers20202021: 1,394 providers20212022: 1,416 providers20222023: 1,590 providers20232024: 1,595 providers20241,59501,0002020: 1,409 providers20202021: 1,394 providers20212022: 1,416 providers20222023: 1,590 providers20232024: 1,595 providers20241,59501,0002020: 1,409 providers20202021: 1,394 providers20212022: 1,416 providers20222023: 1,590 providers20232024: 1,595 providers20241,595

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
20241,595$67,979,748-3%616,141711,2640.00
20231,590$70,250,898-4%635,738781,2000.00
20221,416$73,102,565-5%656,785851,6250.00
20211,394$77,022,470-2%683,697911,9660.00
20201,409$78,399,061first year in data700,837991,7230.00

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
North Carolina132$6,338,60658,00162296
California45$5,527,21349,6011167,759
Georgia117$5,375,94448,272106574
Texas152$4,978,79145,400681,116
New Jersey64$4,737,35342,5411301,856
Massachusetts45$4,026,07036,049833,052
Pennsylvania39$3,456,38130,9973473,379
Michigan30$3,282,08029,4801495,771
Kentucky119$2,928,13226,74546651
Florida102$2,732,63724,41443469
Tennessee86$2,206,67921,03556984
New York32$2,176,87819,8291403,243
Indiana54$2,156,08319,62281785
Nevada16$1,749,07615,6751343,762
Illinois15$1,458,33913,019803,614

Not listed: 18 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ51$6,041,81054,473199
Boston-Cambridge-Newton, MA-NH22$3,280,16429,40494
Detroit-Warren-Dearborn, MI26$3,221,64828,914164
Atlanta-Sandy Springs-Roswell, GA72$2,904,42026,053104
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD42$2,364,69221,252113
Dallas-Fort Worth-Arlington, TX51$2,168,60719,47298
Los Angeles-Long Beach-Anaheim, CA22$2,040,54118,302114
Tampa-St. Petersburg-Clearwater, FL23$1,865,79516,65752
Chicago-Naperville-Elgin, IL-IN25$1,643,51114,69994
San Diego-Chula Vista-Carlsbad, CA11$1,619,19714,502151
Las Vegas-Henderson-North Las Vegas, NV15$1,568,02814,05784
Nashville-Davidson--Murfreesboro--Franklin, TN36$1,246,43411,41874
Houston-Pasadena-The Woodlands, TX20$1,233,33111,068123
Cincinnati, OH-KY-IN22$1,222,70011,06553
Pittsburgh, PA13$1,132,85610,128153

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 42 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2024.

Specialties billing G0480 nationally

Clinical Laboratory accounts for 75% of payment for G0480 nationally in 2024, across 10 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory34622%$50,759,38075%459,2591,327
Nurse Practitioner45529%$3,977,0105.9%36,62480
Interventional Pain Management1117.0%$3,645,8195.4%32,967297
Pain Management1579.8%$2,845,8534.2%25,799164
Anesthesiology1328.3%$1,940,1502.9%17,732134
Physician Assistant19212%$1,732,2212.5%15,88283
Physical Medicine and Rehabilitation865.4%$1,388,8832.0%12,589146
Family Practice291.8%$374,1820.55%3,400117
Psychiatry120.75%$322,3730.47%2,888241
Internal Medicine221.4%$219,8560.32%1,98890

Not listed: 18 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2024.

Top billers of G0480 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations