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#1325 of 11K

T4539

HCPCS Procedure Code

HCPCS code T4539 is the #1,325 most-billed Medicaid procedure code, with $27.4M in payments across 1.0M claims from 2018–2024. The national median cost per claim is $27.96.

Total Paid

$27.4M

0.00% of all spending

Total Claims

1.0M

Providers

146

Avg Cost/Claim

$26

National Cost Distribution

How much do providers bill per claim for T4539? Based on 144 providers billing this code nationally.

Median

$27.96

Average

$27.25

Std Dev

$5.54

Max

$60.00

Percentile Distribution (Cost per Claim)

p10
$20.28
p25
$24.68
Median
$27.96
p75
$30.30
p90
$32.58
p95
$33.23
p99
$35.92

50% of providers bill between $24.68 and $30.30 per claim for this code.

90% bill between $20.28 and $32.58.

Top 1% bill above $35.92.

About This Procedure

HCPCS code T4539 was billed by 146 providers across 1.0M claims, totaling $27.4M in Medicaid payments from 2018–2024. This code was used for 1.0M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$27.96

Providers Billing

144

National Spending

$27.4M

Avg/Median Ratio

0.97×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for T4539

#ProviderTotal Paid
1Integra Partners Llc

Troy, MI · Orthotic Fitter

$3.2M
21639151103$2.1M
31538254461$1.9M
41013367697$1.3M
51003247297$1.2M
61003990664$920K
71356370555$868K
81669635173$800K
91144618794$767K
101245387943$756K
111841273000$630K
121750316055$482K
131699795054$477K
141639243611$465K
151831364397$451K
16Med Star Surgical & Breathing Equipment Inc.

Bronx, NY · Prosthetic/Orthotic Supplier

$411K
171750436259$353K
181437348596$346K
191033181532$340K
201518423508$336K

Showing top 20 of 146 providers billing this code