A4213
HCPCS Procedure Code
HCPCS code A4213 is the #2,626 most-billed Medicaid procedure code, with $4.5M in payments across 277K claims from 2018–2024. The national median cost per claim is $9.01. Costs vary widely — the 90th percentile is $37.73 per claim, 4.2× the median.
Total Paid
$4.5M
0.00% of all spending
Total Claims
277K
Providers
206
Avg Cost/Claim
$16
National Cost Distribution
How much do providers bill per claim for A4213? Based on 198 providers billing this code nationally.
Median
$9.01
Average
$17.05
Std Dev
$28.56
Max
$208.04
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.33 and $18.83 per claim for this code.
90% bill between $1.13 and $37.73.
Top 1% bill above $191.03.
About This Procedure
HCPCS code A4213 was billed by 206 providers across 277K claims, totaling $4.5M in Medicaid payments from 2018–2024. This code was used for 231K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$9.01
Providers Billing
198
National Spending
$4.5M
Avg/Median Ratio
1.89×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for A4213
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1861480048 | $472K |
| 2 | 180 Medical Inc Oklahoma City, OK · Durable Medical Equipment & Medical Supplies, Customized Equipment | $277K |
| 3 | 1760425011 | $255K |
| 4 | 1114923075 | $249K |
| 5 | 1790789238 | $185K |
| 6 | 1457348807 | $184K |
| 7 | Pediatric Home Respiratory Services Llc Roseville, MN · Home Health | $170K |
| 8 | 1659319325 | $166K |
| 9 | 1043213093 | $115K |
| 10 | 1962463075 | $102K |
| 11 | 1902137409 | $91K |
| 12 | 1134120462 | $84K |
| 13 | 1902829500 | $83K |
| 14 | 1427228634 | $83K |
| 15 | 1750445623 | $77K |
| 16 | 1487896957 | $75K |
| 17 | 1972558898 | $72K |
| 18 | 1790849560 | $67K |
| 19 | 1588976815 | $64K |
| 20 | 1548281512 | $64K |
Showing top 20 of 206 providers billing this code