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#229 of 11K

T4528

Adult-sized disposable incontinence product, extra-large

Adult-sized disposable incontinence product, extra-large is the #229 most-billed Medicaid procedure code, with $644.7M in payments across 6.8M claims from 2018–2024. The national median cost per claim is $105.14.

Total Paid

$644.7M

0.06% of all spending

Total Claims

6.8M

Providers

2K

Avg Cost/Claim

$94

National Cost Distribution

How much do providers bill per claim for T4528? Based on 1K providers billing this code nationally.

Median

$105.14

Average

$114.91

Std Dev

$54.05

Max

$718.68

Percentile Distribution (Cost per Claim)

p10
$63.65
p25
$79.68
Median
$105.14
p75
$141.11
p90
$177.21
p95
$198.60
p99
$267.19

50% of providers bill between $79.68 and $141.11 per claim for this code.

90% bill between $63.65 and $177.21.

Top 1% bill above $267.19.

About This Procedure

HCPCS code T4528 (Adult-sized disposable incontinence product, extra-large) was billed by 2K providers across 6.8M claims, totaling $644.7M in Medicaid payments from 2018–2024. This code was used for 6.4M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$105.14

Providers Billing

1K

National Spending

$644.7M

Avg/Median Ratio

1.09×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for T4528

#ProviderTotal Paid
1Activstyle, Llc

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

$28.4M
2Home Care Delivered, Inc.

Richmond, VA · Durable Medical Equipment & Medical Supplies

$26.1M
3Aeroflow Inc

Arden, NC · Durable Medical Equipment & Medical Supplies

$25.1M
4Shield California Health Care Center Inc

Valencia, CA · Durable Medical Equipment & Medical Supplies

$23.6M
5J&b Medical Supply Co Inc

Wixom, MI · Durable Medical Equipment & Medical Supplies

$20.0M
6Personal Touch Home Care Of Ky, Inc.

Fort Thomas, KY · Home Health

$19.5M
7Tenderheart Health Outcomes, Inc.

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

$17.3M
8Binson's Hospital Supplies, Inc.

Center Line, MI · Durable Medical Equipment & Medical Supplies, Customized Equipment

$12.2M
9Medline Industries, Lp

Grayslake, IL · Durable Medical Equipment & Medical Supplies

$12.1M
10J & B Medical Supply Co Inc

Wixom, MI · Durable Medical Equipment & Medical Supplies

$10.0M
11Byram Healthcare Centers, Inc.

Torrance, CA · Durable Medical Equipment & Medical Supplies

$9.6M
121649383084$8.5M
131861576282$6.5M
141124132154$6.3M
151821013590$6.1M
16Byram Healthcare Centers, Inc.

Portland, OR · Durable Medical Equipment & Medical Supplies

$5.2M
17Rgh Enterprises, Llc

Twinsburg, OH · Prosthetic/Orthotic Supplier

$4.6M
181497841704$4.2M
19Byram Healthcare Centers, Inc.

Downers Grove, IL · Durable Medical Equipment & Medical Supplies

$4.0M
201275647299$3.6M

Showing top 20 of 2K providers billing this code