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#2281 of 11K

D4260

HCPCS Procedure Code

HCPCS code D4260 is the #2,281 most-billed Medicaid procedure code, with $7.1M in payments across 15K claims from 2018–2024. The national median cost per claim is $490.00.

Total Paid

$7.1M

0.00% of all spending

Total Claims

15K

Providers

21

Avg Cost/Claim

$474

National Cost Distribution

How much do providers bill per claim for D4260? Based on 21 providers billing this code nationally.

Median

$490.00

Average

$517.63

Std Dev

$99.59

Max

$792.15

Percentile Distribution (Cost per Claim)

p10
$484.62
p25
$488.90
Median
$490.00
p75
$490.00
p90
$690.69
p95
$741.00
p99
$781.92

50% of providers bill between $488.90 and $490.00 per claim for this code.

90% bill between $484.62 and $690.69.

Top 1% bill above $781.92.

About This Procedure

HCPCS code D4260 was billed by 21 providers across 15K claims, totaling $7.1M in Medicaid payments from 2018–2024. This code was used for 5,056 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$490.00

Providers Billing

21

National Spending

$7.1M

Avg/Median Ratio

1.06×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D4260

#ProviderTotal Paid
11124233663$1.7M
21265504617$982K
31255616561$874K
41710036181$738K
51285161323$652K
61720662257$468K
71679932032$339K
81902954506$332K
91417479890$212K
101609013481$178K
111205906872$130K
121003982638$99K
131265588412$85K
141184058984$83K
151942717343$78K
161063543577$56K
171942643564$54K
181518115377$54K
191285796532$25K
201760828776$23K

Showing top 20 of 21 providers billing this code