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#5210 of 11K

A4375

HCPCS Procedure Code

HCPCS code A4375 is the #5,210 most-billed Medicaid procedure code, with $261K in payments across 668 claims from 2018–2024. The national median cost per claim is $322.17.

Total Paid

$261K

0.00% of all spending

Total Claims

668

Providers

3

Avg Cost/Claim

$391

National Cost Distribution

How much do providers bill per claim for A4375? Based on 2 providers billing this code nationally.

Median

$322.17

Average

$322.17

Std Dev

$150.47

Max

$428.57

Percentile Distribution (Cost per Claim)

p10
$237.05
p25
$268.97
Median
$322.17
p75
$375.37
p90
$407.29
p95
$417.93
p99
$426.44

50% of providers bill between $268.97 and $375.37 per claim for this code.

90% bill between $237.05 and $407.29.

Top 1% bill above $426.44.

About This Procedure

HCPCS code A4375 was billed by 3 providers across 668 claims, totaling $261K in Medicaid payments from 2018–2024. This code was used for 616 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$322.17

Providers Billing

2

National Spending

$261K

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.