#556 of 11K

B4154

HCPCS Procedure Code

HCPCS code B4154 is the #556 most-billed Medicaid procedure code, with $148.5M in payments across 1.2M claims from 2018–2024. The national median cost per claim is $132.96. Costs vary widely — the 90th percentile is $316.65 per claim, 2.4× the median.

Total Paid

$148.5M

0.01% of all spending

Total Claims

1.2M

Providers

543

Avg Cost/Claim

$127

National Cost Distribution

How much do providers bill per claim for B4154? Based on 538 providers billing this code nationally.

Median

$132.96

Average

$163.02

Std Dev

$132.47

Max

$1,019.24

Percentile Distribution (Cost per Claim)

p10

$32.03

p25

$76.74

Median

$132.96

p75

$208.27

p90

$316.65

p95

$420.15

p99

$617.85

50% of providers bill between $76.74 and $208.27 per claim for this code.

90% bill between $32.03 and $316.65.

Top 1% bill above $617.85.

About This Procedure

HCPCS code B4154 was billed by 543 providers across 1.2M claims, totaling $148.5M in Medicaid payments from 2018–2024. This code was used for 899K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$132.96

Providers Billing

538

National Spending

$148.5M

Avg/Median Ratio

1.23×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for B4154

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1699709626	$5.6M	$153.98	1.2× median	Above Median
2	1477509628	$5.3M	$141.82	1.1× median	Above Median
3	1346248341	$5.0M	$101.93	0.8× median	Below Median
4	1033267901	$3.2M	$110.27	0.8× median	Below Median
5	Option 1 Nutrition Solutions Llc Denver, CO · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition	$3.1M	$251.11	1.9× median	Above 75th
6	Indiana University Health, Inc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$3.0M	$475.78	3.6× median	Top 10%
7	1336736115	$3.0M	$92.49	0.7× median	Below Median
8	1891106985	$2.9M	$380.79	2.9× median	Top 10%
9	1144358839	$2.7M	$243.77	1.8× median	Above 75th
10	Medco Respiratory Instruments, Inc. Houston, TX · Durable Medical Equipment & Medical Supplies	$2.6M	$346.92	2.6× median	Top 10%
11	Integra Partners Llc Troy, MI · Orthotic Fitter	$2.5M	$110.38	0.8× median	Below Median
12	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$2.3M	$84.16	0.6× median	Below Median
13	1902863434	$2.1M	$114.16	0.9× median	Below Median
14	1265498760	$2.1M	$83.27	0.6× median	Below Median
15	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$1.7M	$138.04	1.0× median	Above Median
16	1033231832	$1.7M	$158.98	1.2× median	Above Median
17	1346270527	$1.5M	$224.25	1.7× median	Above 75th
18	1912101783	$1.5M	$133.72	1.0× median	Above Median
19	1235372848	$1.4M	$416.03	3.1× median	Top 10%
20	Apria Healthcare Llc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$1.4M	$250.09	1.9× median	Above 75th

Showing top 20 of 543 providers billing this code

Related Procedures

B4161Enteral formula, semisolid, 100 calories = 1 unit$1.05B B4160Enteral formula, per 100 calories$628.3M B4149Enteral formula, manufactured blenderized, per 100 calories$259.1M B4150Enteral formula, nutritionally complete with fiber, per 100 calories$254.4M B4152Enteral formula, calorically dense, per 100 calories$183.9M

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