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 (2020 fee schedule; adds 0 work RVUs)

1,409
88th percentile among 6,116 codes billed · 2020
$78M
97th percentile among 6,116 codes billed · 2020
701K
94th percentile among 6,116 codes billed · 2020
99
87th percentile among 6,116 codes billed · 2020
1,723
93rd percentile among 6,116 codes billed · 2020

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
Massachusetts74$6,645,19959,1531422,591
Georgia91$6,069,92753,6431831,427
California48$5,938,12752,7511178,786
North Carolina122$5,834,56653,01898669
Texas121$5,767,63451,856931,345
Pennsylvania32$5,603,70550,0291166,862
Florida100$3,396,34430,48759627
Tennessee100$3,234,42629,364741,042
Washington35$3,203,16428,444742,738
New Jersey42$3,186,91628,2392151,920
New York38$2,895,72425,7251113,740
Illinois17$2,862,22325,282457,180
Kentucky74$2,552,15822,665631,185
Alabama12$1,772,38315,8441496,952
Maryland39$1,474,38413,149631,467

Not listed: 19 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ43$5,134,10945,590170
Boston-Cambridge-Newton, MA-NH31$4,297,53638,207146
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD33$4,001,60235,882194
Chicago-Naperville-Elgin, IL-IN17$2,888,58725,53364
Dallas-Fort Worth-Arlington, TX30$2,873,56325,476171
Atlanta-Sandy Springs-Roswell, GA50$2,862,40125,286142
Seattle-Tacoma-Bellevue, WA14$2,684,06823,818120
Tampa-St. Petersburg-Clearwater, FL15$2,234,95319,774141
Los Angeles-Long Beach-Anaheim, CA25$2,111,14718,90396
San Diego-Chula Vista-Carlsbad, CA12$1,845,37016,348142
Nashville-Davidson--Murfreesboro--Franklin, TN47$1,802,15116,14345
Springfield, MA25$1,558,70713,72692
Houston-Pasadena-The Woodlands, TX20$1,456,34012,877143
Las Vegas-Henderson-North Las Vegas, NV17$1,269,32911,220229
Washington-Arlington-Alexandria, DC-VA-MD-WV18$802,2507,10275

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 37 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing G0480 nationally

Clinical Laboratory accounts for 74% of payment for G0480 nationally in 2020, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory36726%$57,776,17874%516,4081,407
Nurse Practitioner31122%$3,907,4135.0%34,844112
Interventional Pain Management1148.1%$3,654,7164.7%32,448285
Anesthesiology1279.0%$3,413,0744.4%30,350239
Pain Management1268.9%$3,055,5383.9%27,203216
Physical Medicine and Rehabilitation886.2%$2,101,9402.7%18,725213
Physician Assistant15211%$1,614,2372.1%14,41395
Internal Medicine231.6%$766,4540.98%6,819296
Family Practice322.3%$527,7590.67%4,673146

Not listed: 23 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 2020.

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