#1107 of 11K

B4162

HCPCS Procedure Code

HCPCS code B4162 is the #1,107 most-billed Medicaid procedure code, with $40.5M in payments across 116K claims from 2018–2024. The national median cost per claim is $412.82. Costs vary widely — the 90th percentile is $845.95 per claim, 2.0× the median.

Total Paid

$40.5M

0.00% of all spending

Total Claims

116K

Providers

Avg Cost/Claim

$350

National Cost Distribution

How much do providers bill per claim for B4162? Based on 53 providers billing this code nationally.

Median

$412.82

Average

$496.26

Std Dev

$309.13

Max

$1,542.32

Percentile Distribution (Cost per Claim)

p10

$156.82

p25

$268.72

Median

$412.82

p75

$701.54

p90

$845.95

p95

$977.13

p99

$1,406.14

50% of providers bill between $268.72 and $701.54 per claim for this code.

90% bill between $156.82 and $845.95.

Top 1% bill above $1,406.14.

About This Procedure

HCPCS code B4162 was billed by 53 providers across 116K claims, totaling $40.5M in Medicaid payments from 2018–2024. This code was used for 84K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$412.82

Providers Billing

National Spending

$40.5M

Avg/Median Ratio

1.20×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for B4162

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Hhsc Wic Program Austin, TX · Pharmacy	$19.0M	$251.55	0.6× median	Below Median
2	1629013156	$5.2M	$741.55	1.8× median	Above 75th
3	1487896957	$1.7M	$676.00	1.6× median	Above Median
4	Indiana University Health, Inc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$1.1M	$419.20	1.0× median	Above Median
5	Medco Respiratory Instruments, Inc. Houston, TX · Durable Medical Equipment & Medical Supplies	$1.1M	$728.42	1.8× median	Above 75th
6	1184768293	$880K	$396.75	1.0× median	Below Median
7	1801980024	$845K	$884.89	2.1× median	Top 10%
8	1184653388	$844K	$713.84	1.7× median	Above 75th
9	1871509489	$818K	$378.47	0.9× median	Below Median
10	1285140863	$577K	$916.54	2.2× median	Top 10%
11	1194859629	$574K	$713.38	1.7× median	Above 75th
12	1366580391	$531K	$379.27	0.9× median	Below Median
13	1316018070	$485K	$415.28	1.0× median	Above Median
14	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$483K	$356.17	0.9× median	Below Median
15	Option 1 Nutrition Solutions Llc Denver, CO · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition	$461K	$405.13	1.0× median	Below Median
16	1518971928	$456K	$487.99	1.2× median	Above Median
17	1164736146	$421K	$1,542.32	3.7× median	Top 1%
18	1619522943	$404K	$489.70	1.2× median	Above Median
19	1376512194	$400K	$610.44	1.5× median	Above Median
20	1538309331	$383K	$1,280.44	3.1× median	Top 10%

Showing top 20 of 53 providers billing this code

Related Procedures

B4161Enteral formula, semisolid, 100 calories = 1 unit$1.05B B4160Enteral formula, per 100 calories$628.3M B4152Enteral formula, calorically dense, per 100 calories$183.9M B4154$148.5M B4153$143.8M

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