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#3040 of 11K

A4211

HCPCS Procedure Code

HCPCS code A4211 is the #3,040 most-billed Medicaid procedure code, with $2.7M in payments across 33K claims from 2018–2024. The national median cost per claim is $9.60. Costs vary widely — the 90th percentile is $160.89 per claim, 16.8× the median.

Total Paid

$2.7M

0.00% of all spending

Total Claims

33K

Providers

27

Avg Cost/Claim

$82

National Cost Distribution

How much do providers bill per claim for A4211? Based on 26 providers billing this code nationally.

Median

$9.60

Average

$53.79

Std Dev

$86.11

Max

$314.64

Percentile Distribution (Cost per Claim)

p10
$1.14
p25
$8.63
Median
$9.60
p75
$61.49
p90
$160.89
p95
$248.08
p99
$304.05

50% of providers bill between $8.63 and $61.49 per claim for this code.

90% bill between $1.14 and $160.89.

Top 1% bill above $304.05.

About This Procedure

HCPCS code A4211 was billed by 27 providers across 33K claims, totaling $2.7M in Medicaid payments from 2018–2024. This code was used for 14K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.60

Providers Billing

26

National Spending

$2.7M

Avg/Median Ratio

5.60×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A4211

#ProviderTotal Paid
11164735379$1.3M
21972841872$828K
31992908743$216K
41083775621$107K
51134226178$79K
61609899590$52K
71285621193$34K
81912953431$31K
91699714022$12K
101053470955$11K
111518003136$8K
121609912229$4K
131154383362$3K
14Apria Healthcare Llc

Indianapolis, IN · Durable Medical Equipment & Medical Supplies

$3K
151386783629$2K
161760532394$1K
171972577104$745
181750443446$648
191134204738$409
201912930736$343

Showing top 20 of 27 providers billing this code