#3518 of 11K

A4416

HCPCS Procedure Code

HCPCS code A4416 is the #3,518 most-billed Medicaid procedure code, with $1.6M in payments across 24K claims from 2018–2024. The national median cost per claim is $68.00.

Total Paid

$1.6M

0.00% of all spending

Total Claims

24K

Providers

Avg Cost/Claim

$66

National Cost Distribution

How much do providers bill per claim for A4416? Based on 21 providers billing this code nationally.

Median

$68.00

Average

$65.90

Std Dev

$42.70

Max

$162.31

Percentile Distribution (Cost per Claim)

p10

$6.41

p25

$36.85

Median

$68.00

p75

$85.56

p90

$128.11

p95

$132.84

p99

$156.41

50% of providers bill between $36.85 and $85.56 per claim for this code.

90% bill between $6.41 and $128.11.

Top 1% bill above $156.41.

About This Procedure

HCPCS code A4416 was billed by 21 providers across 24K claims, totaling $1.6M in Medicaid payments from 2018–2024. This code was used for 21K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$68.00

Providers Billing

National Spending

$1.6M

Avg/Median Ratio

0.97×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A4416

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$354K	$71.52	1.1× median	Above Median
2	180 Medical Inc Oklahoma City, OK · Durable Medical Equipment & Medical Supplies, Customized Equipment	$161K	$53.38	0.8× median	Below Median
3	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$155K	$162.31	2.4× median	Top 1%
4	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$122K	$72.57	1.1× median	Above Median
5	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$120K	$128.11	1.9× median	Above 75th
6	1881698439	$106K	$61.03	0.9× median	Below Median
7	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$87K	$69.52	1.0× median	Above Median
8	1649244138	$81K	$36.85	0.5× median	Below Median
9	1609024397	$75K	$57.39	0.8× median	Below Median
10	Byram Healthcare Centers, Inc. Portland, OR · Durable Medical Equipment & Medical Supplies	$62K	$85.56	1.3× median	Above 75th
11	1346295953	$60K	$75.96	1.1× median	Above Median
12	1427139641	$52K	$93.65	1.4× median	Above 75th
13	1992891238	$40K	$56.13	0.8× median	Below Median
14	1710932173	$34K	$68.00	1.0× median	Below Median
15	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$30K	$32.46	0.5× median	Below Median
16	1922006741	$26K	$132.84	2.0× median	Top 10%
17	1023063641	$11K	$99.81	1.5× median	Above 75th
18	1164756755	$4K	$6.41	0.1× median	Below Median
19	1437205838	$3K	$5.77	0.1× median	Below Median
20	1053347344	$1K	$5.34	0.1× median	Below Median

Showing top 20 of 21 providers billing this code

Related Procedures

A4409$46.2M A4407$30.9M A4425$26.1M A4414$19.6M A4419$6.5M

← All procedures Top providers →