T4531
HCPCS Procedure Code
HCPCS code T4531 is the #1,701 most-billed Medicaid procedure code, with $15.8M in payments across 169K claims from 2018–2024. The national median cost per claim is $100.68.
Total Paid
$15.8M
0.00% of all spending
Total Claims
169K
Providers
115
Avg Cost/Claim
$93
National Cost Distribution
How much do providers bill per claim for T4531? Based on 112 providers billing this code nationally.
Median
$100.68
Average
$101.42
Std Dev
$50.74
Max
$348.94
Percentile Distribution (Cost per Claim)
50% of providers bill between $70.54 and $117.57 per claim for this code.
90% bill between $52.53 and $159.90.
Top 1% bill above $254.32.
About This Procedure
HCPCS code T4531 was billed by 115 providers across 169K claims, totaling $15.8M in Medicaid payments from 2018–2024. This code was used for 139K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$100.68
Providers Billing
112
National Spending
$15.8M
Avg/Median Ratio
1.01×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for T4531
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1194837229 | $2.7M |
| 2 | Aeroflow Inc Arden, NC · Durable Medical Equipment & Medical Supplies | $1.8M |
| 3 | Personal Touch Home Care Of Ky, Inc. Fort Thomas, KY · Home Health | $1.3M |
| 4 | 1467463836 | $1.0M |
| 5 | 1962440891 | $810K |
| 6 | 1992736425 | $572K |
| 7 | Pediatric Home Respiratory Services Llc Roseville, MN · Home Health | $555K |
| 8 | 1336510080 | $555K |
| 9 | Apple Homecare Medical Supply Llc Richardson, TX · Durable Medical Equipment & Medical Supplies, Customized Equipment | $394K |
| 10 | 1801866173 | $380K |
| 11 | 1710918164 | $361K |
| 12 | Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies | $355K |
| 13 | 1538165642 | $347K |
| 14 | 1629013156 | $296K |
| 15 | J&b Medical Supply Co Inc Wixom, MI · Durable Medical Equipment & Medical Supplies | $241K |
| 16 | 1356410864 | $212K |
| 17 | 1528037538 | $195K |
| 18 | 1649376260 | $173K |
| 19 | Medco Respiratory Instruments, Inc. Houston, TX · Durable Medical Equipment & Medical Supplies | $152K |
| 20 | 1508960436 | $145K |
Showing top 20 of 115 providers billing this code