#2933 of 11K

L4386

HCPCS Procedure Code

HCPCS code L4386 is the #2,933 most-billed Medicaid procedure code, with $3.0M in payments across 32K claims from 2018–2024. The national median cost per claim is $96.14.

Total Paid

$3.0M

0.00% of all spending

Total Claims

32K

Providers

131

Avg Cost/Claim

$93

National Cost Distribution

How much do providers bill per claim for L4386? Based on 129 providers billing this code nationally.

Median

$96.14

Average

$96.63

Std Dev

$52.44

Max

$555.00

Percentile Distribution (Cost per Claim)

p10

$48.80

p25

$81.83

Median

$96.14

p75

$114.51

p90

$131.10

p95

$143.20

p99

$154.42

50% of providers bill between $81.83 and $114.51 per claim for this code.

90% bill between $48.80 and $131.10.

Top 1% bill above $154.42.

About This Procedure

HCPCS code L4386 was billed by 131 providers across 32K claims, totaling $3.0M in Medicaid payments from 2018–2024. This code was used for 30K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$96.14

Providers Billing

129

National Spending

$3.0M

Avg/Median Ratio

1.01×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for L4386

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1790747244	$606K	$111.78	1.2× median	Above Median
2	1366427015	$183K	$147.20	1.5× median	Top 10%
3	1962566562	$176K	$129.24	1.3× median	Above 75th
4	1700119559	$138K	$81.83	0.9× median	Below Median
5	1609124668	$130K	$153.85	1.6× median	Top 10%
6	1053400960	$121K	$108.66	1.1× median	Above Median
7	1215912779	$120K	$95.82	1.0× median	Below Median
8	1689801680	$85K	$116.49	1.2× median	Above 75th
9	1427058650	$68K	$90.95	0.9× median	Below Median
10	1265554984	$67K	$103.34	1.1× median	Above Median
11	1205363546	$66K	$109.46	1.1× median	Above Median
12	1346761897	$61K	$133.14	1.4× median	Top 10%
13	Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children	$59K	$48.31	0.5× median	Below Median
14	1477583011	$48K	$123.22	1.3× median	Above 75th
15	1194766576	$45K	$95.91	1.0× median	Below Median
16	1790873503	$44K	$60.31	0.6× median	Below Median
17	1639314255	$39K	$89.60	0.9× median	Below Median
18	1588994438	$38K	$92.63	1.0× median	Below Median
19	1457650343	$37K	$119.23	1.2× median	Above 75th
20	1215925805	$37K	$120.59	1.3× median	Above 75th

Showing top 20 of 131 providers billing this code

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L4387$10.8M L4396$2.0M

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