A4216
HCPCS Procedure Code
HCPCS code A4216 is the #1,665 most-billed Medicaid procedure code, with $16.6M in payments across 1.0M claims from 2018–2024. The national median cost per claim is $8.45. Costs vary widely — the 90th percentile is $34.36 per claim, 4.1× the median.
Total Paid
$16.6M
0.00% of all spending
Total Claims
1.0M
Providers
720
Avg Cost/Claim
$16
National Cost Distribution
How much do providers bill per claim for A4216? Based on 614 providers billing this code nationally.
Median
$8.45
Average
$17.44
Std Dev
$33.82
Max
$341.84
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.58 and $18.29 per claim for this code.
90% bill between $0.15 and $34.36.
Top 1% bill above $177.80.
About This Procedure
HCPCS code A4216 was billed by 720 providers across 1.0M claims, totaling $16.6M in Medicaid payments from 2018–2024. This code was used for 724K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$8.45
Providers Billing
614
National Spending
$16.6M
Avg/Median Ratio
2.06×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for A4216
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1952333205 | $1.1M |
| 2 | 1770515991 | $765K |
| 3 | 1720019995 | $702K |
| 4 | Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier | $544K |
| 5 | 1619928017 | $544K |
| 6 | 1568493641 | $540K |
| 7 | 1295101533 | $410K |
| 8 | Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies | $391K |
| 9 | 1588697296 | $359K |
| 10 | 1104912732 | $358K |
| 11 | 1649200601 | $347K |
| 12 | 1730174764 | $254K |
| 13 | 1083615991 | $245K |
| 14 | 1902137409 | $239K |
| 15 | 1730221599 | $236K |
| 16 | 1750608147 | $231K |
| 17 | Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies | $228K |
| 18 | 1386688414 | $213K |
| 19 | 1477748119 | $199K |
| 20 | 1568474716 | $193K |
Showing top 20 of 720 providers billing this code