#4993 of 11K

L4205

HCPCS Procedure Code

HCPCS code L4205 is the #4,993 most-billed Medicaid procedure code, with $326K in payments across 12K claims from 2018–2024. The national median cost per claim is $34.83.

Total Paid

$326K

0.00% of all spending

Total Claims

12K

Providers

Avg Cost/Claim

$28

National Cost Distribution

How much do providers bill per claim for L4205? Based on 34 providers billing this code nationally.

Median

$34.83

Average

$40.69

Std Dev

$44.59

Max

$274.36

Percentile Distribution (Cost per Claim)

p10

$16.91

p25

$21.45

Median

$34.83

p75

$40.54

p90

$60.80

p95

$70.32

p99

$211.13

50% of providers bill between $21.45 and $40.54 per claim for this code.

90% bill between $16.91 and $60.80.

Top 1% bill above $211.13.

About This Procedure

HCPCS code L4205 was billed by 37 providers across 12K claims, totaling $326K in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$34.83

Providers Billing

National Spending

$326K

Avg/Median Ratio

1.17×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for L4205

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1679617229	$89K	$16.07	0.5× median	Below Median
2	1487748059	$45K	$63.29	1.8× median	Top 10%
3	1598958720	$22K	$42.15	1.2× median	Above 75th
4	1093777070	$20K	$38.59	1.1× median	Above Median
5	1376544718	$20K	$40.95	1.2× median	Above 75th
6	1265438477	$17K	$34.66	1.0× median	Below Median
7	1245318278	$17K	$52.59	1.5× median	Above 75th
8	1871893644	$16K	$35.01	1.0× median	Above Median
9	1487663514	$12K	$24.46	0.7× median	Below Median
10	1437144797	$11K	$37.40	1.1× median	Above Median
11	1578557021	$8K	$38.16	1.1× median	Above Median
12	1093715849	$8K	$20.15	0.6× median	Below Median
13	1881679629	$6K	$27.28	0.8× median	Below Median
14	1619043932	$6K	$82.75	2.4× median	Top 10%
15	1558398750	$5K	$54.97	1.6× median	Above 75th
16	1265756886	$4K	$39.34	1.1× median	Above Median
17	1871513622	$3K	$274.36	7.9× median	Top 1%
18	1194793588	$3K	$54.50	1.6× median	Above 75th
19	1730141110	$2K	$38.36	1.1× median	Above Median
20	1942431853	$2K	$30.91	0.9× median	Below Median

Showing top 20 of 37 providers billing this code

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