B4197
HCPCS Procedure Code
HCPCS code B4197 is the #1,461 most-billed Medicaid procedure code, with $22.5M in payments across 80K claims from 2018–2024. The national median cost per claim is $687.38.
Total Paid
$22.5M
0.00% of all spending
Total Claims
80K
Providers
19
Avg Cost/Claim
$283
National Cost Distribution
How much do providers bill per claim for B4197? Based on 19 providers billing this code nationally.
Median
$687.38
Average
$676.99
Std Dev
$473.75
Max
$1,607.71
Percentile Distribution (Cost per Claim)
50% of providers bill between $240.13 and $986.34 per claim for this code.
90% bill between $145.02 and $1,239.17.
Top 1% bill above $1,560.48.
About This Procedure
HCPCS code B4197 was billed by 19 providers across 80K claims, totaling $22.5M in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$687.38
Providers Billing
19
National Spending
$22.5M
Avg/Median Ratio
0.98×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for B4197
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1770528994 | $5.8M |
| 2 | 1417978479 | $5.1M |
| 3 | 1417472812 | $2.9M |
| 4 | 1881727998 | $1.7M |
| 5 | 1457381782 | $1.7M |
| 6 | 1457872632 | $974K |
| 7 | 1811085103 | $676K |
| 8 | 1285687749 | $638K |
| 9 | Indiana University Health, Inc Indianapolis, IN · Durable Medical Equipment & Medical Supplies | $599K |
| 10 | 1184653388 | $540K |
| 11 | 1992920383 | $501K |
| 12 | 1952440604 | $446K |
| 13 | 1245866383 | $425K |
| 14 | 1396852000 | $221K |
| 15 | 1841732237 | $151K |
| 16 | 1326279746 | $128K |
| 17 | 1346270527 | $35K |
| 18 | 1518036458 | $22K |
| 19 | 1760417232 | $396 |
Showing top 19 of 19 providers billing this code