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#3168 of 11K

A4206

HCPCS Procedure Code

HCPCS code A4206 is the #3,168 most-billed Medicaid procedure code, with $2.3M in payments across 214K claims from 2018–2024. The national median cost per claim is $1.96. Costs vary widely — the 90th percentile is $31.36 per claim, 16.0× the median.

Total Paid

$2.3M

0.00% of all spending

Total Claims

214K

Providers

147

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for A4206? Based on 124 providers billing this code nationally.

Median

$1.96

Average

$12.08

Std Dev

$20.17

Max

$135.84

Percentile Distribution (Cost per Claim)

p10
$0.01
p25
$0.08
Median
$1.96
p75
$18.74
p90
$31.36
p95
$39.50
p99
$95.37

50% of providers bill between $0.08 and $18.74 per claim for this code.

90% bill between $0.01 and $31.36.

Top 1% bill above $95.37.

About This Procedure

HCPCS code A4206 was billed by 147 providers across 214K claims, totaling $2.3M in Medicaid payments from 2018–2024. This code was used for 163K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1.96

Providers Billing

124

National Spending

$2.3M

Avg/Median Ratio

6.16×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A4206

#ProviderTotal Paid
1J&b Medical Supply Co Inc

Wixom, MI · Durable Medical Equipment & Medical Supplies

$411K
21104800440$284K
31972526861$209K
4Byram Healthcare Centers, Inc.

Portland, OR · Durable Medical Equipment & Medical Supplies

$184K
5Rgh Enterprises, Llc

Twinsburg, OH · Prosthetic/Orthotic Supplier

$176K
61730221599$163K
71194880526$140K
81356732382$138K
91700836541$105K
101972687556$96K
111497796122$87K
121487605093$58K
131811222748$36K
141114923075$33K
151134120462$19K
161659458073$17K
171356388771$16K
181588976815$14K
191518086032$9K
201134304595$9K

Showing top 20 of 147 providers billing this code