#1505 of 11K

B4036

HCPCS Procedure Code

HCPCS code B4036 is the #1,505 most-billed Medicaid procedure code, with $20.9M in payments across 263K claims from 2018–2024. The national median cost per claim is $74.87. Costs vary widely — the 90th percentile is $150.87 per claim, 2.0× the median.

Total Paid

$20.9M

0.00% of all spending

Total Claims

263K

Providers

220

Avg Cost/Claim

$80

National Cost Distribution

How much do providers bill per claim for B4036? Based on 214 providers billing this code nationally.

Median

$74.87

Average

$80.39

Std Dev

$51.04

Max

$250.75

Percentile Distribution (Cost per Claim)

p10

$17.57

p25

$37.12

Median

$74.87

p75

$115.54

p90

$150.87

p95

$170.24

p99

$215.04

50% of providers bill between $37.12 and $115.54 per claim for this code.

90% bill between $17.57 and $150.87.

Top 1% bill above $215.04.

About This Procedure

HCPCS code B4036 was billed by 220 providers across 263K claims, totaling $20.9M in Medicaid payments from 2018–2024. This code was used for 195K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$74.87

Providers Billing

214

National Spending

$20.9M

Avg/Median Ratio

1.07×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for B4036

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Indiana University Health, Inc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$1.2M	$144.64	1.9× median	Above 75th
2	1770581498	$1.0M	$158.25	2.1× median	Top 10%
3	1326096629	$939K	$119.39	1.6× median	Above 75th
4	1326140138	$804K	$250.75	3.3× median	Top 1%
5	1366580391	$645K	$81.00	1.1× median	Above Median
6	Option 1 Nutrition Solutions Llc Denver, CO · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition	$580K	$165.73	2.2× median	Top 10%
7	1780663823	$569K	$69.49	0.9× median	Below Median
8	1881799666	$521K	$84.15	1.1× median	Above Median
9	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$503K	$61.11	0.8× median	Below Median
10	1346270527	$471K	$33.48	0.4× median	Below Median
11	1649485848	$452K	$36.65	0.5× median	Below Median
12	1497831507	$433K	$172.42	2.3× median	Top 10%
13	1902829500	$432K	$181.09	2.4× median	Top 10%
14	1184768293	$424K	$161.07	2.2× median	Top 10%
15	1871509489	$367K	$78.92	1.1× median	Above Median
16	1245383348	$338K	$203.36	2.7× median	Top 10%
17	Pediatric Home Respiratory Services Llc Roseville, MN · Home Health	$309K	$185.43	2.5× median	Top 10%
18	1790036671	$307K	$160.47	2.1× median	Top 10%
19	Medco Respiratory Instruments, Inc. Houston, TX · Durable Medical Equipment & Medical Supplies	$298K	$125.46	1.7× median	Above 75th
20	1972534154	$292K	$61.85	0.8× median	Below Median

Showing top 20 of 220 providers billing this code

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