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#546 of 11K

L4361

HCPCS Procedure Code

HCPCS code L4361 is the #546 most-billed Medicaid procedure code, with $152.7M in payments across 947K claims from 2018–2024. The national median cost per claim is $161.24.

Total Paid

$152.7M

0.01% of all spending

Total Claims

947K

Providers

653

Avg Cost/Claim

$161

National Cost Distribution

How much do providers bill per claim for L4361? Based on 646 providers billing this code nationally.

Median

$161.24

Average

$159.35

Std Dev

$64.44

Max

$491.01

Percentile Distribution (Cost per Claim)

p10
$82.88
p25
$115.26
Median
$161.24
p75
$199.67
p90
$237.79
p95
$260.21
p99
$310.65

50% of providers bill between $115.26 and $199.67 per claim for this code.

90% bill between $82.88 and $237.79.

Top 1% bill above $310.65.

About This Procedure

HCPCS code L4361 was billed by 653 providers across 947K claims, totaling $152.7M in Medicaid payments from 2018–2024. This code was used for 863K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$161.24

Providers Billing

646

National Spending

$152.7M

Avg/Median Ratio

0.99×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for L4361

#ProviderTotal Paid
1Djo, Llc

Carlsbad, CA · Prosthetic/Orthotic Supplier

$25.7M
21891787594$14.3M
31326048893$12.9M
41306836465$7.0M
51669417531$6.3M
61790747244$3.7M
71669532248$2.0M
81457354219$2.0M
91861573685$1.8M
101700119559$1.8M
111962413765$1.8M
121710900857$1.7M
131467826263$1.7M
141285082610$1.7M
151831289826$1.5M
161053440321$1.3M
171750582920$1.3M
181871038034$1.3M
191275784001$1.2M
201447553144$1.2M

Showing top 20 of 653 providers billing this code

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