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#5821 of 11K

X4542

HCPCS Procedure Code

HCPCS code X4542 is the #5,821 most-billed Medicaid procedure code, with $133K in payments across 2,756 claims from 2018–2024. The national median cost per claim is $40.65.

Total Paid

$133K

0.00% of all spending

Total Claims

2,756

Providers

6

Avg Cost/Claim

$48

National Cost Distribution

How much do providers bill per claim for X4542? Based on 6 providers billing this code nationally.

Median

$40.65

Average

$44.38

Std Dev

$8.84

Max

$60.92

Percentile Distribution (Cost per Claim)

p10
$38.38
p25
$38.54
Median
$40.65
p75
$46.16
p90
$54.11
p95
$57.52
p99
$60.24

50% of providers bill between $38.54 and $46.16 per claim for this code.

90% bill between $38.38 and $54.11.

Top 1% bill above $60.24.

About This Procedure

HCPCS code X4542 was billed by 6 providers across 2,756 claims, totaling $133K in Medicaid payments from 2018–2024. This code was used for 2,714 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$40.65

Providers Billing

6

National Spending

$133K

Avg/Median Ratio

1.09×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for X4542

#ProviderTotal Paid
1Children's Hospital & Research Center At Oakland

Oakland, CA · General Acute Care Hospital

$65K
21902846306$33K
31134218332$13K
41760491021$12K
51710065933$9K
61962800235$925

Showing top 6 of 6 providers billing this code