#4713 of 11K

A4364

HCPCS Procedure Code

HCPCS code A4364 is the #4,713 most-billed Medicaid procedure code, with $438K in payments across 44K claims from 2018–2024. The national median cost per claim is $6.21. Costs vary widely — the 90th percentile is $23.05 per claim, 3.7× the median.

Total Paid

$438K

0.00% of all spending

Total Claims

44K

Providers

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for A4364? Based on 53 providers billing this code nationally.

Median

$6.21

Average

$10.65

Std Dev

$12.18

Max

$56.90

Percentile Distribution (Cost per Claim)

p10

$2.25

p25

$4.44

Median

$6.21

p75

$11.24

p90

$23.05

p95

$39.16

p99

$53.57

50% of providers bill between $4.44 and $11.24 per claim for this code.

90% bill between $2.25 and $23.05.

Top 1% bill above $53.57.

About This Procedure

HCPCS code A4364 was billed by 64 providers across 44K claims, totaling $438K in Medicaid payments from 2018–2024. This code was used for 40K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.21

Providers Billing

National Spending

$438K

Avg/Median Ratio

1.71×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A4364

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$86K	$11.24	1.8× median	Above Median
2	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$65K	$24.37	3.9× median	Top 10%
3	1003813064	$40K	$21.73	3.5× median	Above 75th
4	1801899414	$34K	$21.45	3.5× median	Above 75th
5	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$32K	$22.26	3.6× median	Above 75th
6	J&b Medical Supply Co Inc Wixom, MI · Durable Medical Equipment & Medical Supplies	$13K	$6.40	1.0× median	Above Median
7	1881698439	$13K	$7.60	1.2× median	Above Median
8	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$13K	$6.62	1.1× median	Above Median
9	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$12K	$5.65	0.9× median	Below Median
10	1710932173	$11K	$12.65	2.0× median	Above 75th
11	1841558160	$11K	$9.65	1.6× median	Above Median
12	1366653545	$10K	$5.56	0.9× median	Below Median
13	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$8K	$4.64	0.7× median	Below Median
14	1275647299	$8K	$50.49	8.1× median	Top 10%
15	1093711996	$7K	$8.62	1.4× median	Above Median
16	1962452755	$7K	$5.38	0.9× median	Below Median
17	1649244138	$6K	$3.21	0.5× median	Below Median
18	1992891238	$5K	$4.21	0.7× median	Below Median
19	1477534717	$5K	$6.33	1.0× median	Above Median
20	180 Medical Inc Oklahoma City, OK · Durable Medical Equipment & Medical Supplies, Customized Equipment	$5K	$5.38	0.9× median	Below Median

Showing top 20 of 64 providers billing this code

Related Procedures

A4362$21.0M A4357Bedside drainage bag, day or night$13.1M A4358$5.3M A4373$2.8M A4371$2.7M

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