#4277 of 11K

A4428

HCPCS Procedure Code

HCPCS code A4428 is the #4,277 most-billed Medicaid procedure code, with $697K in payments across 12K claims from 2018–2024. The national median cost per claim is $56.83. Costs vary widely — the 90th percentile is $126.30 per claim, 2.2× the median.

Total Paid

$697K

0.00% of all spending

Total Claims

12K

Providers

Avg Cost/Claim

$56

National Cost Distribution

How much do providers bill per claim for A4428? Based on 16 providers billing this code nationally.

Median

$56.83

Average

$66.18

Std Dev

$40.11

Max

$134.13

Percentile Distribution (Cost per Claim)

p10

$23.24

p25

$42.77

Median

$56.83

p75

$91.41

p90

$126.30

p95

$132.11

p99

$133.73

50% of providers bill between $42.77 and $91.41 per claim for this code.

90% bill between $23.24 and $126.30.

Top 1% bill above $133.73.

About This Procedure

HCPCS code A4428 was billed by 16 providers across 12K claims, totaling $697K in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$56.83

Providers Billing

National Spending

$697K

Avg/Median Ratio

1.16×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A4428

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$228K	$63.42	1.1× median	Above Median
2	180 Medical Inc Oklahoma City, OK · Durable Medical Equipment & Medical Supplies, Customized Equipment	$71K	$43.04	0.8× median	Below Median
3	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$68K	$131.43	2.3× median	Top 10%
4	1649244138	$64K	$41.96	0.7× median	Below Median
5	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$58K	$113.81	2.0× median	Above 75th
6	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$56K	$59.88	1.1× median	Above Median
7	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$51K	$63.94	1.1× median	Above Median
8	Binson's Hospital Supplies, Inc. Center Line, MI · Durable Medical Equipment & Medical Supplies, Customized Equipment	$42K	$83.94	1.5× median	Above Median
9	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$30K	$49.03	0.9× median	Below Median
10	1013124213	$7K	$8.66	0.2× median	Below Median
11	1881698439	$6K	$37.82	0.7× median	Below Median
12	Byram Healthcare Centers, Inc. Portland, OR · Durable Medical Equipment & Medical Supplies	$5K	$134.13	2.4× median	Top 1%
13	1053347344	$5K	$7.07	0.1× median	Below Median
14	1992891238	$4K	$45.77	0.8× median	Below Median
15	1710932173	$2K	$121.17	2.1× median	Above 75th
16	1477534717	$645	$53.78	0.9× median	Below Median

Showing top 16 of 16 providers billing this code

Related Procedures

A4425$26.1M A4419$6.5M A4424$5.8M A4432$4.5M A4427$1.8M

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