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#2103 of 11K

A4394

HCPCS Procedure Code

HCPCS code A4394 is the #2,103 most-billed Medicaid procedure code, with $8.9M in payments across 579K claims from 2018–2024. The national median cost per claim is $12.65. Costs vary widely — the 90th percentile is $26.01 per claim, 2.1× the median.

Total Paid

$8.9M

0.00% of all spending

Total Claims

579K

Providers

178

Avg Cost/Claim

$15

National Cost Distribution

How much do providers bill per claim for A4394? Based on 176 providers billing this code nationally.

Median

$12.65

Average

$13.96

Std Dev

$9.99

Max

$75.96

Percentile Distribution (Cost per Claim)

p10
$2.14
p25
$7.16
Median
$12.65
p75
$18.82
p90
$26.01
p95
$32.02
p99
$37.84

50% of providers bill between $7.16 and $18.82 per claim for this code.

90% bill between $2.14 and $26.01.

Top 1% bill above $37.84.

About This Procedure

HCPCS code A4394 was billed by 178 providers across 579K claims, totaling $8.9M in Medicaid payments from 2018–2024. This code was used for 512K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.65

Providers Billing

176

National Spending

$8.9M

Avg/Median Ratio

1.10×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A4394

#ProviderTotal Paid
1Rgh Enterprises, Llc

Twinsburg, OH · Prosthetic/Orthotic Supplier

$930K
21609024397$661K
3Byram Healthcare Centers, Inc.

Torrance, CA · Durable Medical Equipment & Medical Supplies

$578K
4Shield California Health Care Center Inc

Valencia, CA · Durable Medical Equipment & Medical Supplies

$565K
5Byram Healthcare Centers, Inc.

Downers Grove, IL · Durable Medical Equipment & Medical Supplies

$472K
6Byram Healthcare Centers, Inc.

Portland, OR · Durable Medical Equipment & Medical Supplies

$349K
71881698439$346K
81710932173$287K
91992891238$269K
101023438538$247K
11180 Medical Inc

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

$238K
121649244138$232K
131346295953$209K
14Home Care Delivered, Inc.

Richmond, VA · Durable Medical Equipment & Medical Supplies

$200K
151902055445$157K
161922006741$154K
171679653356$132K
18Binson's Hospital Supplies, Inc.

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

$129K
19Shield Denver Health Care Center Inc

Aurora, CO · Durable Medical Equipment & Medical Supplies

$120K
20J&b Medical Supply Co Inc

Wixom, MI · Durable Medical Equipment & Medical Supplies

$107K

Showing top 20 of 178 providers billing this code