0004A
HCPCS Procedure Code
HCPCS code 0004A is the #1,539 most-billed Medicaid procedure code, with $19.8M in payments across 583K claims from 2018–2024. The national median cost per claim is $35.62.
Total Paid
$19.8M
0.00% of all spending
Total Claims
583K
Providers
4K
Avg Cost/Claim
$34
National Cost Distribution
How much do providers bill per claim for 0004A? Based on 3K providers billing this code nationally.
Median
$35.62
Average
$37.03
Std Dev
$47.51
Max
$808.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $24.83 and $40.00 per claim for this code.
90% bill between $7.65 and $47.98.
Top 1% bill above $179.46.
About This Procedure
HCPCS code 0004A was billed by 4K providers across 583K claims, totaling $19.8M in Medicaid payments from 2018–2024. This code was used for 531K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$35.62
Providers Billing
3K
National Spending
$19.8M
Avg/Median Ratio
1.04×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 0004A
| # | Provider | Total Paid |
|---|---|---|
| 1 | Dhhs Phs Naihs Shiprock Hospital Shiprock, NM · General Acute Care Hospital | $893K |
| 2 | Dhhs,phs,naihs, Gallup Indian Medical Center Gallup, NM · General Acute Care Hospital | $495K |
| 3 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $451K |
| 4 | Permanente Medical Group Inc Stockton, CA · Anesthesiology | $319K |
| 5 | Utah Navajo Health System, Incorporated Montezuma Creek, UT · Family Medicine | $305K |
| 6 | State Of Indiana Auditor Of State Indianapolis, IN · Public Health or Welfare | $272K |
| 7 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $211K |
| 8 | New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine | $197K |
| 9 | Tanana Chiefs Conference Fairbanks, AK · Clinic/Center Multi-Specialty | $186K |
| 10 | Zuni Indian Hospital Zuni, NM · General Acute Care Hospital | $179K |
| 11 | New York City Health And Hospitals Corporation Elmhurst, NY · Internal Medicine | $179K |
| 12 | Permanente Medical Group Inc Richmond, CA · Internal Medicine | $169K |
| 13 | St. Johns Community Health Los Angeles, CA · Case Manager/Care Coordinator | $159K |
| 14 | New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine | $158K |
| 15 | Group Health Plan, Inc. Minneapolis, MN · Clinic/Center, Multi-Specialty | $154K |
| 16 | City & County Of San Francisco San Francisco, CA · Case Manager/Care Coordinator | $153K |
| 17 | Medical Associates Of Ebnhc East Boston, MA · Clinic/Center, Community Health | $147K |
| 18 | Mid Atlantic Pemanente Medical Group Rockville, MD · Health Maintenance Organization | $142K |
| 19 | New York City Health And Hospitals Corporation Jamaica, NY · General Acute Care Hospital | $134K |
| 20 | New York City Health And Hospitals Corporation New York, NY · Internal Medicine | $131K |
Showing top 20 of 4K providers billing this code