A4209
HCPCS Procedure Code
HCPCS code A4209 is the #3,591 most-billed Medicaid procedure code, with $1.5M in payments across 194K claims from 2018–2024. The national median cost per claim is $1.41. Costs vary widely — the 90th percentile is $17.99 per claim, 12.8× the median.
Total Paid
$1.5M
0.00% of all spending
Total Claims
194K
Providers
98
Avg Cost/Claim
$7
National Cost Distribution
How much do providers bill per claim for A4209? Based on 91 providers billing this code nationally.
Median
$1.41
Average
$6.74
Std Dev
$14.48
Max
$108.28
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.38 and $8.08 per claim for this code.
90% bill between $0.04 and $17.99.
Top 1% bill above $56.91.
About This Procedure
HCPCS code A4209 was billed by 98 providers across 194K claims, totaling $1.5M in Medicaid payments from 2018–2024. This code was used for 103K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$1.41
Providers Billing
91
National Spending
$1.5M
Avg/Median Ratio
4.78×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for A4209
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1902829500 | $303K |
| 2 | 1457348807 | $253K |
| 3 | 1730221599 | $235K |
| 4 | 1114923075 | $92K |
| 5 | 1134120462 | $81K |
| 6 | 1588976815 | $68K |
| 7 | 1629507579 | $48K |
| 8 | 1578868774 | $46K |
| 9 | 1497389845 | $34K |
| 10 | 1871596916 | $29K |
| 11 | 1548281512 | $29K |
| 12 | 1194880526 | $25K |
| 13 | 1528020633 | $24K |
| 14 | Pediatric Home Respiratory Services Llc Roseville, MN · Home Health | $18K |
| 15 | 1780868224 | $18K |
| 16 | 1831241033 | $15K |
| 17 | 1356455638 | $11K |
| 18 | 1275637324 | $11K |
| 19 | 1568809598 | $11K |
| 20 | Riverside University Health Systems - Medical Center Moreno Valley, CA · General Acute Care Hospital | $10K |
Showing top 20 of 98 providers billing this code