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#1350 of 11K

A4425

HCPCS Procedure Code

HCPCS code A4425 is the #1,350 most-billed Medicaid procedure code, with $26.1M in payments across 642K claims from 2018–2024. The national median cost per claim is $38.79.

Total Paid

$26.1M

0.00% of all spending

Total Claims

642K

Providers

217

Avg Cost/Claim

$41

National Cost Distribution

How much do providers bill per claim for A4425? Based on 213 providers billing this code nationally.

Median

$38.79

Average

$40.74

Std Dev

$24.66

Max

$148.07

Percentile Distribution (Cost per Claim)

p10
$9.22
p25
$25.85
Median
$38.79
p75
$52.25
p90
$65.53
p95
$88.77
p99
$118.32

50% of providers bill between $25.85 and $52.25 per claim for this code.

90% bill between $9.22 and $65.53.

Top 1% bill above $118.32.

About This Procedure

HCPCS code A4425 was billed by 217 providers across 642K claims, totaling $26.1M in Medicaid payments from 2018–2024. This code was used for 565K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$38.79

Providers Billing

213

National Spending

$26.1M

Avg/Median Ratio

1.05×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A4425

#ProviderTotal Paid
1Rgh Enterprises, Llc

Twinsburg, OH · Prosthetic/Orthotic Supplier

$3.7M
2Shield California Health Care Center Inc

Valencia, CA · Durable Medical Equipment & Medical Supplies

$2.4M
3Byram Healthcare Centers, Inc.

Torrance, CA · Durable Medical Equipment & Medical Supplies

$1.6M
4Byram Healthcare Centers, Inc.

Downers Grove, IL · Durable Medical Equipment & Medical Supplies

$1.2M
5180 Medical Inc

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

$876K
61710932173$797K
7Shield Denver Health Care Center Inc

Aurora, CO · Durable Medical Equipment & Medical Supplies

$786K
81649244138$739K
91609024397$641K
10Home Care Delivered, Inc.

Richmond, VA · Durable Medical Equipment & Medical Supplies

$611K
111992891238$521K
12Byram Healthcare Centers, Inc.

Portland, OR · Durable Medical Equipment & Medical Supplies

$486K
131881698439$480K
141386688414$461K
15Medline Industries, Lp

Grayslake, IL · Durable Medical Equipment & Medical Supplies

$457K
161275647299$451K
171902055445$422K
181427139641$380K
19Continuum, Llc

Philadelphia, PA · Durable Medical Equipment & Medical Supplies

$369K
201801899414$343K

Showing top 20 of 217 providers billing this code