A4312
HCPCS Procedure Code
HCPCS code A4312 is the #4,058 most-billed Medicaid procedure code, with $884K in payments across 27K claims from 2018–2024. The national median cost per claim is $15.57. Costs vary widely — the 90th percentile is $103.93 per claim, 6.7× the median.
Total Paid
$884K
0.00% of all spending
Total Claims
27K
Providers
11
Avg Cost/Claim
$33
National Cost Distribution
How much do providers bill per claim for A4312? Based on 8 providers billing this code nationally.
Median
$15.57
Average
$43.58
Std Dev
$79.68
Max
$236.05
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.54 and $35.33 per claim for this code.
90% bill between $0.65 and $103.93.
Top 1% bill above $222.83.
About This Procedure
HCPCS code A4312 was billed by 11 providers across 27K claims, totaling $884K in Medicaid payments from 2018–2024. This code was used for 6K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$15.57
Providers Billing
8
National Spending
$884K
Avg/Median Ratio
2.80×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for A4312
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1366580391 | $599K |
| 2 | 1770998494 | $257K |
| 3 | 1568465185 | $19K |
| 4 | 1649244138 | $4K |
| 5 | 1992891238 | $2K |
| 6 | 1013124213 | $2K |
| 7 | Riverside Hospital Inc Newport News, VA · Psychiatric Hospital | $36 |
| 8 | Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies | $12 |
| 9 | 1831132133 | $0 |
| 10 | Samaritan Hospital Of Troy, New York Troy, NY | $0 |
| 11 | 1497701106 | $0 |
Showing top 11 of 11 providers billing this code