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#209 of 11K

T4526

Adult-sized disposable incontinence product, medium

Adult-sized disposable incontinence product, medium is the #209 most-billed Medicaid procedure code, with $740.7M in payments across 10.1M claims from 2018–2024. The national median cost per claim is $88.94.

Total Paid

$740.7M

0.07% of all spending

Total Claims

10.1M

Providers

2K

Avg Cost/Claim

$73

National Cost Distribution

How much do providers bill per claim for T4526? Based on 2K providers billing this code nationally.

Median

$88.94

Average

$91.51

Std Dev

$41.02

Max

$640.59

Percentile Distribution (Cost per Claim)

p10
$46.80
p25
$63.97
Median
$88.94
p75
$114.47
p90
$136.40
p95
$148.24
p99
$196.75

50% of providers bill between $63.97 and $114.47 per claim for this code.

90% bill between $46.80 and $136.40.

Top 1% bill above $196.75.

About This Procedure

HCPCS code T4526 (Adult-sized disposable incontinence product, medium) was billed by 2K providers across 10.1M claims, totaling $740.7M in Medicaid payments from 2018–2024. This code was used for 9.6M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$88.94

Providers Billing

2K

National Spending

$740.7M

Avg/Median Ratio

1.03×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for T4526

#ProviderTotal Paid
1Shield California Health Care Center Inc

Valencia, CA · Durable Medical Equipment & Medical Supplies

$36.1M
2Aeroflow Inc

Arden, NC · Durable Medical Equipment & Medical Supplies

$27.2M
3Home Care Delivered, Inc.

Richmond, VA · Durable Medical Equipment & Medical Supplies

$25.0M
4Activstyle, Llc

Saint Paul, MN · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition

$23.1M
5J&b Medical Supply Co Inc

Wixom, MI · Durable Medical Equipment & Medical Supplies

$22.8M
6Tenderheart Health Outcomes, Inc.

Austin, TX · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition

$18.3M
7Medline Industries, Lp

Grayslake, IL · Durable Medical Equipment & Medical Supplies

$14.4M
8Byram Healthcare Centers, Inc.

Torrance, CA · Durable Medical Equipment & Medical Supplies

$11.5M
9Personal Touch Home Care Of Ky, Inc.

Fort Thomas, KY · Home Health

$11.5M
10Binson's Hospital Supplies, Inc.

Center Line, MI · Durable Medical Equipment & Medical Supplies, Customized Equipment

$9.3M
11J & B Medical Supply Co Inc

Wixom, MI · Durable Medical Equipment & Medical Supplies

$8.9M
121124132154$7.5M
131861576282$7.2M
141649383084$6.5M
151992861736$6.5M
16Rgh Enterprises, Llc

Twinsburg, OH · Prosthetic/Orthotic Supplier

$6.2M
171619913357$6.0M
18Byram Healthcare Centers, Inc.

Portland, OR · Durable Medical Equipment & Medical Supplies

$5.5M
191467467050$5.5M
201821013590$5.4M

Showing top 20 of 2K providers billing this code