A4231
HCPCS Procedure Code
HCPCS code A4231 is the #1,459 most-billed Medicaid procedure code, with $22.5M in payments across 202K claims from 2018–2024. The national median cost per claim is $93.81.
Total Paid
$22.5M
0.00% of all spending
Total Claims
202K
Providers
52
Avg Cost/Claim
$112
National Cost Distribution
How much do providers bill per claim for A4231? Based on 52 providers billing this code nationally.
Median
$93.81
Average
$100.78
Std Dev
$57.78
Max
$363.09
Percentile Distribution (Cost per Claim)
50% of providers bill between $67.87 and $124.73 per claim for this code.
90% bill between $50.45 and $152.79.
Top 1% bill above $299.09.
About This Procedure
HCPCS code A4231 was billed by 52 providers across 202K claims, totaling $22.5M in Medicaid payments from 2018–2024. This code was used for 188K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$93.81
Providers Billing
52
National Spending
$22.5M
Avg/Median Ratio
1.07×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for A4231
| # | Provider | Total Paid |
|---|---|---|
| 1 | Minimed Distribution Corp. Northridge, CA · Durable Medical Equipment & Medical Supplies | $4.4M |
| 2 | Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier | $2.9M |
| 3 | Degc Enterprises (U.s.), Inc. Clearwater, FL · Durable Medical Equipment & Medical Supplies | $2.1M |
| 4 | Edwards Health Care Services, Inc. Hudson, OH · Durable Medical Equipment & Medical Supplies | $2.0M |
| 5 | 1962731570 | $1.9M |
| 6 | 1619295516 | $1.9M |
| 7 | 1184777286 | $1.7M |
| 8 | 1467488148 | $663K |
| 9 | 1730159617 | $603K |
| 10 | Medical Express Depot Inc. Pittsburgh, PA · Durable Medical Equipment & Medical Supplies | $577K |
| 11 | 1295801421 | $515K |
| 12 | 1932240702 | $468K |
| 13 | Edwards Health Care Services Inc. Morehead City, NC · Durable Medical Equipment & Medical Supplies | $453K |
| 14 | 1164537452 | $231K |
| 15 | J&b Medical Supply Co Inc Wixom, MI · Durable Medical Equipment & Medical Supplies | $219K |
| 16 | 1346332863 | $211K |
| 17 | 1770512501 | $200K |
| 18 | 1093711996 | $179K |
| 19 | 1316903545 | $168K |
| 20 | Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies | $130K |
Showing top 20 of 52 providers billing this code