K0004
HCPCS Procedure Code
HCPCS code K0004 is the #2,082 most-billed Medicaid procedure code, with $9.3M in payments across 176K claims from 2018–2024. The national median cost per claim is $34.32. Costs vary widely — the 90th percentile is $87.48 per claim, 2.5× the median.
Total Paid
$9.3M
0.00% of all spending
Total Claims
176K
Providers
205
Avg Cost/Claim
$53
National Cost Distribution
How much do providers bill per claim for K0004? Based on 203 providers billing this code nationally.
Median
$34.32
Average
$55.34
Std Dev
$109.45
Max
$1,233.72
Percentile Distribution (Cost per Claim)
50% of providers bill between $16.99 and $56.88 per claim for this code.
90% bill between $7.32 and $87.48.
Top 1% bill above $466.57.
About This Procedure
HCPCS code K0004 was billed by 205 providers across 176K claims, totaling $9.3M in Medicaid payments from 2018–2024. This code was used for 155K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$34.32
Providers Billing
203
National Spending
$9.3M
Avg/Median Ratio
1.61×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for K0004
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1518037787 | $2.3M |
| 2 | 1366478901 | $661K |
| 3 | 1194796847 | $321K |
| 4 | Med Star Surgical & Breathing Equipment Inc. Bronx, NY · Prosthetic/Orthotic Supplier | $221K |
| 5 | 1922071034 | $195K |
| 6 | 1497703516 | $193K |
| 7 | 1417927997 | $184K |
| 8 | 1003924713 | $174K |
| 9 | 1851328157 | $173K |
| 10 | 1912987132 | $159K |
| 11 | 1104912732 | $155K |
| 12 | 1235389347 | $154K |
| 13 | Binson's Hospital Supplies, Inc. Center Line, MI · Durable Medical Equipment & Medical Supplies, Customized Equipment | $144K |
| 14 | Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies | $141K |
| 15 | 1235372848 | $137K |
| 16 | 1669406609 | $126K |
| 17 | 1447355300 | $123K |
| 18 | 1407851561 | $121K |
| 19 | 1336202811 | $114K |
| 20 | 1376858969 | $113K |
Showing top 20 of 205 providers billing this code