T4537
HCPCS Procedure Code
HCPCS code T4537 is the #536 most-billed Medicaid procedure code, with $160.0M in payments across 5.1M claims from 2018–2024. The national median cost per claim is $31.50.
Total Paid
$160.0M
0.01% of all spending
Total Claims
5.1M
Providers
656
Avg Cost/Claim
$31
National Cost Distribution
How much do providers bill per claim for T4537? Based on 649 providers billing this code nationally.
Median
$31.50
Average
$36.29
Std Dev
$21.84
Max
$129.03
Percentile Distribution (Cost per Claim)
50% of providers bill between $25.42 and $39.70 per claim for this code.
90% bill between $16.21 and $61.50.
Top 1% bill above $110.52.
About This Procedure
HCPCS code T4537 was billed by 656 providers across 5.1M claims, totaling $160.0M in Medicaid payments from 2018–2024. This code was used for 5.0M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$31.50
Providers Billing
649
National Spending
$160.0M
Avg/Median Ratio
1.15×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for T4537
| # | Provider | Total Paid |
|---|---|---|
| 1 | Binson's Hospital Supplies, Inc. Center Line, MI · Durable Medical Equipment & Medical Supplies, Customized Equipment | $12.0M |
| 2 | Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies | $6.3M |
| 3 | Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies | $5.6M |
| 4 | 1821013590 | $5.5M |
| 5 | J&b Medical Supply Co Inc Wixom, MI · Durable Medical Equipment & Medical Supplies | $5.0M |
| 6 | Integra Partners Llc Troy, MI · Orthotic Fitter | $4.7M |
| 7 | Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies | $4.3M |
| 8 | Activstyle, Llc Saint Paul, MN · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | $4.2M |
| 9 | 1164493003 | $3.1M |
| 10 | 1245387943 | $2.9M |
| 11 | 1639151103 | $2.7M |
| 12 | 1992975700 | $2.6M |
| 13 | 1538254461 | $2.3M |
| 14 | 1972693968 | $2.3M |
| 15 | Med Star Surgical & Breathing Equipment Inc. Bronx, NY · Prosthetic/Orthotic Supplier | $2.2M |
| 16 | 1346248341 | $2.1M |
| 17 | 1699795054 | $2.1M |
| 18 | 1174917579 | $2.1M |
| 19 | 1043215106 | $2.0M |
| 20 | 1205837879 | $1.8M |
Showing top 20 of 656 providers billing this code