#4378 of 11K

X4540

HCPCS Procedure Code

HCPCS code X4540 is the #4,378 most-billed Medicaid procedure code, with $623K in payments across 22K claims from 2018–2024. The national median cost per claim is $25.93.

Total Paid

$623K

0.00% of all spending

Total Claims

22K

Providers

Avg Cost/Claim

$28

National Cost Distribution

How much do providers bill per claim for X4540? Based on 22 providers billing this code nationally.

Median

$25.93

Average

$27.08

Std Dev

$5.57

Max

$32.91

Percentile Distribution (Cost per Claim)

p10

$20.71

p25

$21.69

Median

$25.93

p75

$32.81

p90

$32.91

p95

$32.91

p99

$32.91

50% of providers bill between $21.69 and $32.81 per claim for this code.

90% bill between $20.71 and $32.91.

Top 1% bill above $32.91.

About This Procedure

HCPCS code X4540 was billed by 22 providers across 22K claims, totaling $623K in Medicaid payments from 2018–2024. This code was used for 22K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$25.93

Providers Billing

National Spending

$623K

Avg/Median Ratio

1.04×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for X4540

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Children's Hospital & Research Center At Oakland Oakland, CA · General Acute Care Hospital	$280K	$32.77	1.3× median	Above Median
2	1649366501	$159K	$21.21	0.8× median	Below Median
3	1811946734	$57K	$32.90	1.3× median	Above 75th
4	1467442749	$36K	$32.85	1.3× median	Above 75th
5	1700949336	$23K	$32.69	1.3× median	Above Median
6	1952777245	$23K	$32.83	1.3× median	Above 75th
7	Childrens Hospital Of Los Angeles Los Angeles, CA · Case Manager/Care Coordinator	$14K	$32.52	1.3× median	Above Median
8	1760491021	$6K	$20.50	0.8× median	Below Median
9	1215993704	$5K	$21.94	0.8× median	Below Median
10	1437555265	$4K	$21.60	0.8× median	Below Median
11	Regents Of The University Of California Sacramento, CA · General Acute Care Hospital	$3K	$32.91	1.3× median	Top 1%
12	1164577433	$3K	$22.85	0.9× median	Below Median
13	1942236633	$2K	$22.94	0.9× median	Below Median
14	1710065933	$2K	$28.93	1.1× median	Above Median
15	1902803315	$1K	$32.50	1.3× median	Above Median
16	1982715512	$908	$22.71	0.9× median	Below Median
17	1811080526	$856	$32.91	1.3× median	Top 1%
18	1730571332	$833	$21.35	0.8× median	Below Median
19	1275285603	$609	$22.55	0.9× median	Below Median
20	1700804200	$395	$32.91	1.3× median	Top 1%

Showing top 20 of 22 providers billing this code

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