#3013 of 11K

B9004

HCPCS Procedure Code

HCPCS code B9004 is the #3,013 most-billed Medicaid procedure code, with $2.8M in payments across 18K claims from 2018–2024. The national median cost per claim is $122.59. Costs vary widely — the 90th percentile is $292.16 per claim, 2.4× the median.

Total Paid

$2.8M

0.00% of all spending

Total Claims

18K

Providers

Avg Cost/Claim

$151

National Cost Distribution

How much do providers bill per claim for B9004? Based on 27 providers billing this code nationally.

Median

$122.59

Average

$161.57

Std Dev

$106.49

Max

$452.70

Percentile Distribution (Cost per Claim)

p10

$56.89

p25

$82.58

Median

$122.59

p75

$211.76

p90

$292.16

p95

$349.29

p99

$430.41

50% of providers bill between $82.58 and $211.76 per claim for this code.

90% bill between $56.89 and $292.16.

Top 1% bill above $430.41.

About This Procedure

HCPCS code B9004 was billed by 27 providers across 18K claims, totaling $2.8M in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$122.59

Providers Billing

National Spending

$2.8M

Avg/Median Ratio

1.32×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for B9004

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1760425011	$849K	$281.58	2.3× median	Above 75th
2	Indiana University Health, Inc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$533K	$261.36	2.1× median	Above 75th
3	1457872632	$430K	$82.06	0.7× median	Below Median
4	1326096629	$322K	$95.57	0.8× median	Below Median
5	1992920383	$219K	$452.70	3.7× median	Top 1%
6	1609899590	$78K	$78.29	0.6× median	Below Median
7	1164735379	$57K	$205.50	1.7× median	Above Median
8	1245866383	$45K	$42.22	0.3× median	Below Median
9	1780663823	$44K	$218.02	1.8× median	Above 75th
10	1912930736	$30K	$248.52	2.0× median	Above 75th
11	1750517108	$24K	$83.85	0.7× median	Below Median
12	1629174214	$23K	$160.79	1.3× median	Above Median
13	1326140138	$20K	$108.19	0.9× median	Below Median
14	1457395394	$19K	$193.44	1.6× median	Above Median
15	1497528418	$13K	$83.10	0.7× median	Below Median
16	1285687749	$10K	$366.97	3.0× median	Top 10%
17	1134226178	$8K	$196.22	1.6× median	Above Median
18	1841732237	$8K	$31.24	0.3× median	Below Median
19	1740268614	$7K	$181.13	1.5× median	Above Median
20	1356348866	$7K	$84.36	0.7× median	Below Median

Showing top 20 of 27 providers billing this code

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