How much does Medicare pay for HCPCS G0399?

Medicare allowed an average of $67.71 per service and paid $50.35 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $461.13, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does G0399 pay differently in an office than a hospital?

Yes. The allowed amount averaged $68.94 in an office setting and $44.51 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills G0399 most?

Pulmonary Disease, with 28,537 services from 465 clinicians. Next are Independent Diagnostic Testing Facility (IDTF), Sleep Medicine, Neurology.

HCPCS G0399

Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation

$67.71Medicare-allowed amount per service, averaged across 68,427 services

Providers submitted

$461.13

Asking price, not received

Medicare allowed

$67.71

The fee schedule figure

Medicare paid

$50.35

Balance is patient coinsurance

Providers submitted an average of $461.13 for this code and Medicare allowed $67.71 — 6.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $50.35 (74%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $68.94
Hospital / facility: $44.51

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 65,000 services were billed in an office setting and 3,427 in a facility.

Services: 68,427
Beneficiaries: 61,974
Providers billing it: 1,066
Total allowed: $4,633,192

What Medicare pays for HCPCS G0399

Across 68,427 services billed by 1,066 providers to 61,974 beneficiaries, Medicare allowed an average of $67.71 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills G0399

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	28,537	27,236	$66.64	465
Independent Diagnostic Testing Facility (IDTF)	11,485	8,292	$77.65	62
Sleep Medicine	10,603	10,278	$61.68	200
Neurology	6,404	5,820	$66.20	115
Internal Medicine	4,756	4,426	$66.96	91
Critical Care (Intensivists)	1,803	1,688	$64.95	37
Otolaryngology	1,602	1,494	$67.03	32
Family Practice	1,364	1,023	$75.26	23
Psychiatry	513	505	$48.48	10
Cardiology	463	341	$74.19	9
Neuropsychiatry	277	274	$41.25	2
Hospitalist	223	220	$75.49	6
Pediatric Medicine	122	121	$53.41	5
Undefined Physician type	98	98	$101.81	1
Nurse Practitioner	51	39	$71.11	3

G0399 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	9,107	$82.28	$61.99	74
Florida	5,700	$73.46	$54.35	84
Pennsylvania	3,610	$59.60	$44.03	72
Washington	3,328	$69.98	$51.64	56
Illinois	3,294	$58.33	$43.81	56
Michigan	2,604	$56.85	$41.28	63
Wisconsin	2,489	$49.06	$34.96	44
Kentucky	2,488	$93.34	$67.68	24
Texas	2,314	$71.80	$55.26	46
Arizona	2,285	$76.71	$58.19	44
Indiana	2,003	$49.04	$35.98	40
Massachusetts	1,856	$80.12	$60.18	27
New Jersey	1,856	$70.33	$54.56	22
Missouri	1,819	$44.68	$31.84	23
New York	1,740	$59.96	$44.68	44
South Carolina	1,507	$63.22	$46.65	13
Ohio	1,483	$102.38	$75.84	45
Iowa	1,407	$56.23	$40.64	8
New Hampshire	1,390	$45.33	$32.97	21
South Dakota	1,365	$43.02	$30.91	11
North Carolina	1,279	$59.83	$44.48	27
Kansas	1,218	$53.01	$37.97	6
Idaho	1,115	$46.25	$34.31	14
Oregon	1,069	$77.21	$55.41	21
Nebraska	1,009	$71.75	$52.35	10
Louisiana	954	$54.26	$40.26	12
Tennessee	907	$50.97	$38.43	22
Georgia	897	$70.93	$53.73	17
Nevada	799	$91.09	$68.64	6
Maryland	668	$80.03	$60.86	10
Virginia	638	$55.87	$41.52	13
Connecticut	570	$46.51	$34.07	12
Minnesota	508	$58.53	$43.83	17
Utah	418	$81.29	$60.57	10
Colorado	369	$86.63	$66.71	5
Delaware	303	$90.52	$67.89	4
Maine	284	$57.55	$40.27	4
District of Columbia	245	$90.43	$66.19	5
Montana	245	$64.97	$47.54	5
Alaska	220	$75.03	$52.20	3
Hawaii	191	$87.88	$69.62	3
Alabama	159	$66.85	$50.17	5
Wyoming	145	$81.58	$58.14	2
Vermont	135	$67.47	$48.80	2
Oklahoma	108	$50.60	$39.91	2
North Dakota	95	$49.76	$37.10	3
New Mexico	79	$85.03	$65.92	3
Arkansas	42	$61.92	$44.50	3
West Virginia	42	$96.09	$71.88	1
Rhode Island	40	$100.49	$76.13	1
Puerto Rico	31	$89.69	$71.46	1

Related codes

G0316Prolonged hospital inpatient or observation care evaluation and manage$28.58
G0328Colorectal cancer screening; fecal occult blood test$17.64
G0318Prolonged home or residence evaluation and management service(s) beyon$27.69
G0317Prolonged nursing facility evaluation and management service(s) beyond$27.01
G0396Alcohol and/or substance (other than tobacco) misuse structured assess$32.81
G0306Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) a$7.60
G0307Complete (cbc)$6.33
G0340Image-guided robotic linear accelerator-based stereotactic radiosurger$2145.82
G0323Care management services for behavioral health conditions$43.42
G0398Home sleep study test (hst)$127.41
G0339Image-guided robotic linear accelerator-based stereotactic radiosurger$2840.40
G0372Physician service required to establish and document the need for a po$7.68

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.