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#1767 of 11K

T4536

Adult disposable incontinence product, pull-on, large

Adult disposable incontinence product, pull-on, large is the #1,767 most-billed Medicaid procedure code, with $14.3M in payments across 1.2M claims from 2018–2024. The national median cost per claim is $11.57.

Total Paid

$14.3M

0.00% of all spending

Total Claims

1.2M

Providers

114

Avg Cost/Claim

$12

National Cost Distribution

How much do providers bill per claim for T4536? Based on 106 providers billing this code nationally.

Median

$11.57

Average

$15.86

Std Dev

$19.13

Max

$119.87

Percentile Distribution (Cost per Claim)

p10
$7.61
p25
$10.23
Median
$11.57
p75
$12.55
p90
$19.25
p95
$25.59
p99
$113.90

50% of providers bill between $10.23 and $12.55 per claim for this code.

90% bill between $7.61 and $19.25.

Top 1% bill above $113.90.

About This Procedure

HCPCS code T4536 (Adult disposable incontinence product, pull-on, large) was billed by 114 providers across 1.2M claims, totaling $14.3M in Medicaid payments from 2018–2024. This code was used for 1.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.57

Providers Billing

106

National Spending

$14.3M

Avg/Median Ratio

1.37×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for T4536

#ProviderTotal Paid
11467471342$1.3M
21134305972$1.1M
31558466763$814K
41962738468$716K
51922071034$559K
61861472672$498K
71205976438$454K
81437154713$449K
91104174838$443K
101497704548$442K
111891840039$424K
121386699221$397K
131730592098$394K
141063710986$386K
151083607212$378K
161124162748$377K
171215087333$371K
181639231483$353K
191013169762$297K
201790966760$229K

Showing top 20 of 114 providers billing this code