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 (2023 fee schedule; adds 0 work RVUs)

1,590
89th percentile among 6,405 codes billed · 2023
$70M
97th percentile among 6,405 codes billed · 2023
636K
94th percentile among 6,405 codes billed · 2023
78
82nd percentile among 6,405 codes billed · 2023
1,200
88th percentile among 6,405 codes billed · 2023
-3.9%
Medicare payment on the code vs 2022; billers +12.3% · 2023

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 Carolina148$5,861,77954,25964282
California47$5,610,19150,412678,458
Texas144$5,580,82450,879831,176
Georgia107$5,143,40646,10591730
Massachusetts45$4,742,57642,4211294,247
New Jersey49$4,495,97240,4852631,869
Pennsylvania42$3,969,53335,5562733,718
Kentucky127$3,224,93329,29655567
Florida135$3,150,15428,17057281
New York31$2,371,51021,4971653,797
Tennessee71$2,069,29618,97084885
Indiana50$1,969,73117,854100742
Illinois21$1,887,32716,852471,106
Michigan27$1,714,40215,5452651,509
Nevada14$1,664,78014,9132294,797

Not listed: 16 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ40$5,940,99053,559318
Boston-Cambridge-Newton, MA-NH19$3,781,10333,843155
Atlanta-Sandy Springs-Roswell, GA65$2,823,88825,27286
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD38$2,635,56423,636266
Dallas-Fort Worth-Arlington, TX53$2,395,50421,48387
Chicago-Naperville-Elgin, IL-IN30$2,070,60218,512110
Tampa-St. Petersburg-Clearwater, FL40$1,975,06517,63759
Los Angeles-Long Beach-Anaheim, CA26$1,891,52116,97868
Detroit-Warren-Dearborn, MI22$1,631,37114,769353
Las Vegas-Henderson-North Las Vegas, NV13$1,571,20914,074142
Cincinnati, OH-KY-IN15$1,526,15213,708108
Houston-Pasadena-The Woodlands, TX20$1,346,46112,097150
Pittsburgh, PA14$1,263,68411,29580
Seattle-Tacoma-Bellevue, WA12$1,208,02210,85365
Nashville-Davidson--Murfreesboro--Franklin, TN36$1,135,23410,38046

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 43 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing G0480 nationally

Clinical Laboratory accounts for 73% of payment for G0480 nationally in 2023, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory37323%$51,231,54573%463,1141,242
Interventional Pain Management1308.2%$4,252,7136.1%38,329295
Nurse Practitioner41226%$3,925,9445.6%35,93187
Pain Management1479.2%$2,504,3843.6%22,687154
Anesthesiology1348.4%$2,492,4273.5%22,627169
Physician Assistant19212%$2,155,0643.1%19,618102
Physical Medicine and Rehabilitation845.3%$1,539,8552.2%13,918166
Family Practice342.1%$437,2440.62%3,989117
Internal Medicine271.7%$314,4980.45%2,902107

Not listed: 22 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 2023.

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