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#5313 of 11K

4004F

HCPCS Procedure Code

HCPCS code 4004F is the #5,313 most-billed Medicaid procedure code, with $231K in payments across 3.3M claims from 2018–2024. The national median cost per claim is $0.02. Costs vary widely — the 90th percentile is $9.03 per claim, 451.5× the median.

Total Paid

$231K

0.00% of all spending

Total Claims

3.3M

Providers

2,550

Avg Cost/Claim

$0

National Cost Distribution

How much do providers bill per claim for 4004F? Based on 204 providers billing this code nationally.

Median

$0.02

Average

$3.03

Std Dev

$8.69

Max

$53.97

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.00
Median
$0.02
p75
$0.33
p90
$9.03
p95
$22.93
p99
$41.11

50% of providers bill between $0.00 and $0.33 per claim for this code.

90% bill between $0.00 and $9.03.

Top 1% bill above $41.11.

About This Procedure

HCPCS code 4004F was billed by 2,550 providers across 3.3M claims, totaling $231K in Medicaid payments from 2018–2024. This code was used for 2.6M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.02

Providers Billing

204

National Spending

$231K

Avg/Median Ratio

151.50×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 4004F

#ProviderTotal Paid
11669708756$67K
21336185164$43K
31407031446$15K
41023561248$13K
51548728553$13K
61730136680$7K
71336148931$7K
81518303288$6K
91770697278$6K
101467439463$5K
111568794279$3K
121598853889$3K
131760689715$3K
141487867206$3K
151114060969$3K
161588089759$3K
171114342243$2K
181306944335$2K
191225122963$2K
201134543457$2K

Showing top 20 of 2,550 providers billing this code