#3324 of 11K

A4314

HCPCS Procedure Code

HCPCS code A4314 is the #3,324 most-billed Medicaid procedure code, with $1.9M in payments across 442K claims from 2018–2024. The national median cost per claim is $5.42. Costs vary widely — the 90th percentile is $22.30 per claim, 4.1× the median.

Total Paid

$1.9M

0.00% of all spending

Total Claims

442K

Providers

146

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for A4314? Based on 134 providers billing this code nationally.

Median

$5.42

Average

$10.07

Std Dev

$14.61

Max

$118.30

Percentile Distribution (Cost per Claim)

p10

$0.75

p25

$2.25

Median

$5.42

p75

$12.11

p90

$22.30

p95

$36.20

p99

$64.06

50% of providers bill between $2.25 and $12.11 per claim for this code.

90% bill between $0.75 and $22.30.

Top 1% bill above $64.06.

About This Procedure

HCPCS code A4314 was billed by 146 providers across 442K claims, totaling $1.9M in Medicaid payments from 2018–2024. This code was used for 375K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.42

Providers Billing

134

National Spending

$1.9M

Avg/Median Ratio

1.86×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A4314

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1649244138	$159K	$5.18	1.0× median	Below Median
2	1013124213	$151K	$2.24	0.4× median	Below Median
3	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$132K	$11.69	2.2× median	Above Median
4	1053347344	$96K	$1.64	0.3× median	Below Median
5	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$82K	$40.01	7.4× median	Top 10%
6	1164756755	$79K	$1.29	0.2× median	Below Median
7	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$79K	$14.59	2.7× median	Above 75th
8	1487624193	$76K	$20.95	3.9× median	Above 75th
9	1386688414	$75K	$37.41	6.9× median	Top 10%
10	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$57K	$15.65	2.9× median	Above 75th
11	1376916379	$51K	$2.39	0.4× median	Below Median
12	J&b Medical Supply Co Inc Wixom, MI · Durable Medical Equipment & Medical Supplies	$45K	$9.86	1.8× median	Above Median
13	1275960965	$42K	$4.43	0.8× median	Below Median
14	1730174764	$39K	$7.45	1.4× median	Above Median
15	1033190137	$37K	$8.71	1.6× median	Above Median
16	1881698439	$32K	$9.52	1.8× median	Above Median
17	1366440968	$30K	$2.83	0.5× median	Below Median
18	1992891238	$28K	$11.04	2.0× median	Above Median
19	1275626822	$28K	$23.22	4.3× median	Top 10%
20	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$27K	$13.01	2.4× median	Above 75th

Showing top 20 of 146 providers billing this code

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