T4543
Pediatric-sized disposable incontinence product, above XL
Pediatric-sized disposable incontinence product, above XL is the #475 most-billed Medicaid procedure code, with $197.9M in payments across 1.2M claims from 2018–2024. The national median cost per claim is $177.75.
Total Paid
$197.9M
0.02% of all spending
Total Claims
1.2M
Providers
489
Avg Cost/Claim
$163
National Cost Distribution
How much do providers bill per claim for T4543? Based on 486 providers billing this code nationally.
Median
$177.75
Average
$186.39
Std Dev
$75.35
Max
$606.71
Percentile Distribution (Cost per Claim)
50% of providers bill between $134.27 and $226.89 per claim for this code.
90% bill between $109.75 and $271.91.
Top 1% bill above $434.77.
About This Procedure
HCPCS code T4543 (Pediatric-sized disposable incontinence product, above XL) was billed by 489 providers across 1.2M claims, totaling $197.9M in Medicaid payments from 2018–2024. This code was used for 1.1M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$177.75
Providers Billing
486
National Spending
$197.9M
Avg/Median Ratio
1.05×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for T4543
| # | Provider | Total Paid |
|---|---|---|
| 1 | Aeroflow Inc Arden, NC · Durable Medical Equipment & Medical Supplies | $10.4M |
| 2 | Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies | $8.5M |
| 3 | Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies | $7.7M |
| 4 | Integra Partners Llc Troy, MI · Orthotic Fitter | $5.5M |
| 5 | J & B Medical Supply Co Inc Wixom, MI · Durable Medical Equipment & Medical Supplies | $5.1M |
| 6 | J&b Medical Supply Co Inc Wixom, MI · Durable Medical Equipment & Medical Supplies | $4.7M |
| 7 | 1245387943 | $3.9M |
| 8 | 1699795054 | $3.4M |
| 9 | Activstyle, Llc Saint Paul, MN · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | $3.2M |
| 10 | 1821013590 | $3.0M |
| 11 | 1750316055 | $3.0M |
| 12 | 1164493003 | $2.7M |
| 13 | Med Star Surgical & Breathing Equipment Inc. Bronx, NY · Prosthetic/Orthotic Supplier | $2.6M |
| 14 | 1013911056 | $2.5M |
| 15 | Tenderheart Health Outcomes, Inc. Austin, TX · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | $2.5M |
| 16 | 1093814774 | $2.2M |
| 17 | 1306990619 | $2.1M |
| 18 | 1619988284 | $2.1M |
| 19 | 1710932173 | $2.0M |
| 20 | 1013367697 | $2.0M |
Showing top 20 of 489 providers billing this code