#1254 of 11K

A4407

HCPCS Procedure Code

HCPCS code A4407 is the #1,254 most-billed Medicaid procedure code, with $30.9M in payments across 377K claims from 2018–2024. The national median cost per claim is $73.73. Costs vary widely — the 90th percentile is $155.11 per claim, 2.1× the median.

Total Paid

$30.9M

0.00% of all spending

Total Claims

377K

Providers

149

Avg Cost/Claim

$82

National Cost Distribution

How much do providers bill per claim for A4407? Based on 148 providers billing this code nationally.

Median

$73.73

Average

$86.61

Std Dev

$60.34

Max

$425.19

Percentile Distribution (Cost per Claim)

p10

$21.47

p25

$53.85

Median

$73.73

p75

$111.26

p90

$155.11

p95

$185.34

p99

$310.16

50% of providers bill between $53.85 and $111.26 per claim for this code.

90% bill between $21.47 and $155.11.

Top 1% bill above $310.16.

About This Procedure

HCPCS code A4407 was billed by 149 providers across 377K claims, totaling $30.9M in Medicaid payments from 2018–2024. This code was used for 330K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$73.73

Providers Billing

148

National Spending

$30.9M

Avg/Median Ratio

1.17×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A4407

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$4.9M	$82.75	1.1× median	Above Median
2	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$2.7M	$218.20	3.0× median	Top 10%
3	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$2.2M	$145.72	2.0× median	Above 75th
4	1609024397	$1.9M	$115.71	1.6× median	Above 75th
5	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$1.9M	$62.18	0.8× median	Below Median
6	180 Medical Inc Oklahoma City, OK · Durable Medical Equipment & Medical Supplies, Customized Equipment	$1.2M	$63.49	0.9× median	Below Median
7	1710932173	$895K	$81.86	1.1× median	Above Median
8	1649244138	$865K	$50.30	0.7× median	Below Median
9	Byram Healthcare Centers, Inc. Portland, OR · Durable Medical Equipment & Medical Supplies	$765K	$105.51	1.4× median	Above Median
10	1992891238	$695K	$60.55	0.8× median	Below Median
11	1881698439	$694K	$54.52	0.7× median	Below Median
12	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$669K	$71.29	1.0× median	Below Median
13	1427139641	$569K	$93.88	1.3× median	Above Median
14	1346295953	$567K	$75.40	1.0× median	Above Median
15	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$500K	$43.79	0.6× median	Below Median
16	1902055445	$491K	$112.16	1.5× median	Above 75th
17	Shield Denver Health Care Center Inc Aurora, CO · Durable Medical Equipment & Medical Supplies	$488K	$188.22	2.6× median	Top 10%
18	1922006741	$407K	$129.18	1.8× median	Above 75th
19	1275647299	$395K	$306.58	4.2× median	Top 10%
20	1023438538	$393K	$92.41	1.3× median	Above Median

Showing top 20 of 149 providers billing this code

Related Procedures

A4409$46.2M A4414$19.6M A4406$6.5M A4402$4.5M A4410$3.2M

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