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#2749 of 11K

L4397

HCPCS Procedure Code

HCPCS code L4397 is the #2,749 most-billed Medicaid procedure code, with $3.9M in payments across 43K claims from 2018–2024. The national median cost per claim is $97.67.

Total Paid

$3.9M

0.00% of all spending

Total Claims

43K

Providers

69

Avg Cost/Claim

$90

National Cost Distribution

How much do providers bill per claim for L4397? Based on 69 providers billing this code nationally.

Median

$97.67

Average

$91.84

Std Dev

$38.82

Max

$197.72

Percentile Distribution (Cost per Claim)

p10
$47.26
p25
$73.56
Median
$97.67
p75
$119.71
p90
$129.75
p95
$144.15
p99
$167.38

50% of providers bill between $73.56 and $119.71 per claim for this code.

90% bill between $47.26 and $129.75.

Top 1% bill above $167.38.

About This Procedure

HCPCS code L4397 was billed by 69 providers across 43K claims, totaling $3.9M in Medicaid payments from 2018–2024. This code was used for 26K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$97.67

Providers Billing

69

National Spending

$3.9M

Avg/Median Ratio

0.94×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for L4397

#ProviderTotal Paid
1Podiatry Center Of New Jersey, Llc

Wayne, NJ · Clinic/Center, Podiatric

$2.0M
2Djo, Llc

Carlsbad, CA · Prosthetic/Orthotic Supplier

$371K
31427179753$189K
41326048893$188K
51689628752$126K
61891787594$123K
71093901100$108K
81306836465$95K
91538194394$85K
101679603724$77K
111134331788$68K
121205023033$47K
131740690874$32K
141205387461$31K
151194801142$28K
161871538207$27K
171760564181$23K
181568402576$21K
191851337604$20K
201386643856$19K

Showing top 20 of 69 providers billing this code