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#4737 of 11K

A4315

HCPCS Procedure Code

HCPCS code A4315 is the #4,737 most-billed Medicaid procedure code, with $425K in payments across 67K claims from 2018–2024. The national median cost per claim is $10.63. Costs vary widely — the 90th percentile is $28.23 per claim, 2.7× the median.

Total Paid

$425K

0.00% of all spending

Total Claims

67K

Providers

40

Avg Cost/Claim

$6

National Cost Distribution

How much do providers bill per claim for A4315? Based on 34 providers billing this code nationally.

Median

$10.63

Average

$17.44

Std Dev

$30.97

Max

$177.75

Percentile Distribution (Cost per Claim)

p10
$1.62
p25
$2.76
Median
$10.63
p75
$16.76
p90
$28.23
p95
$44.84
p99
$137.61

50% of providers bill between $2.76 and $16.76 per claim for this code.

90% bill between $1.62 and $28.23.

Top 1% bill above $137.61.

About This Procedure

HCPCS code A4315 was billed by 40 providers across 67K claims, totaling $425K in Medicaid payments from 2018–2024. This code was used for 58K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$10.63

Providers Billing

34

National Spending

$425K

Avg/Median Ratio

1.64×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A4315

#ProviderTotal Paid
1Women & Infants Hospital Of Rhode Island

Providence, RI · Clinic/Center, Ambulatory Family Planning Facility

$115K
21013124213$89K
31649244138$41K
4J&b Medical Supply Co Inc

Wixom, MI · Durable Medical Equipment & Medical Supplies

$36K
51992891238$25K
6Medline Industries, Lp

Grayslake, IL · Durable Medical Equipment & Medical Supplies

$19K
7Continuum, Llc

Philadelphia, PA · Durable Medical Equipment & Medical Supplies

$18K
8Home Care Delivered, Inc.

Richmond, VA · Durable Medical Equipment & Medical Supplies

$17K
9180 Medical Inc

Oklahoma City, OK · Durable Medical Equipment & Medical Supplies, Customized Equipment

$9K
10Rgh Enterprises, Llc

Twinsburg, OH · Prosthetic/Orthotic Supplier

$7K
111376916379$6K
121063771798$5K
13Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$5K
141881698439$5K
151730174764$4K
161366440968$3K
171992162911$3K
18Byram Healthcare Centers, Inc.

Torrance, CA · Durable Medical Equipment & Medical Supplies

$2K
191053347344$2K
20Binson's Hospital Supplies, Inc.

Center Line, MI · Durable Medical Equipment & Medical Supplies, Customized Equipment

$2K

Showing top 20 of 40 providers billing this code