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#355 of 11K

T4522

Adult-sized disposable incontinence product, brief/diaper, above XL

Adult-sized disposable incontinence product, brief/diaper, above XL is the #355 most-billed Medicaid procedure code, with $353.5M in payments across 5.5M claims from 2018–2024. The national median cost per claim is $84.50.

Total Paid

$353.5M

0.03% of all spending

Total Claims

5.5M

Providers

1K

Avg Cost/Claim

$64

National Cost Distribution

How much do providers bill per claim for T4522? Based on 1K providers billing this code nationally.

Median

$84.50

Average

$86.01

Std Dev

$35.17

Max

$389.12

Percentile Distribution (Cost per Claim)

p10
$49.06
p25
$65.29
Median
$84.50
p75
$101.82
p90
$121.18
p95
$141.16
p99
$197.61

50% of providers bill between $65.29 and $101.82 per claim for this code.

90% bill between $49.06 and $121.18.

Top 1% bill above $197.61.

About This Procedure

HCPCS code T4522 (Adult-sized disposable incontinence product, brief/diaper, above XL) was billed by 1K providers across 5.5M claims, totaling $353.5M in Medicaid payments from 2018–2024. This code was used for 5.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$84.50

Providers Billing

1K

National Spending

$353.5M

Avg/Median Ratio

1.02×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for T4522

#ProviderTotal Paid
1Shield California Health Care Center Inc

Valencia, CA · Durable Medical Equipment & Medical Supplies

$18.4M
21245387943$11.7M
3J&b Medical Supply Co Inc

Wixom, MI · Durable Medical Equipment & Medical Supplies

$11.3M
4Medline Industries, Lp

Grayslake, IL · Durable Medical Equipment & Medical Supplies

$9.5M
5Integra Partners Llc

Troy, MI · Orthotic Fitter

$8.5M
6Home Care Delivered, Inc.

Richmond, VA · Durable Medical Equipment & Medical Supplies

$8.1M
71659365849$6.5M
81699795054$6.5M
91306990619$6.1M
10Activstyle, Llc

Saint Paul, MN · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition

$5.8M
11Med Star Surgical & Breathing Equipment Inc.

Bronx, NY · Prosthetic/Orthotic Supplier

$5.6M
12Byram Healthcare Centers, Inc.

Torrance, CA · Durable Medical Equipment & Medical Supplies

$5.5M
131710932173$4.4M
14J & B Medical Supply Co Inc

Wixom, MI · Durable Medical Equipment & Medical Supplies

$4.3M
151750316055$4.3M
161013911056$4.1M
171649383084$3.8M
18Personal Touch Home Care Of Ky, Inc.

Fort Thomas, KY · Home Health

$3.6M
191467467050$3.4M
20Tenderheart Health Outcomes, Inc.

Austin, TX · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition

$3.3M

Showing top 20 of 1K providers billing this code