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#5400 of 11K

A4461

HCPCS Procedure Code

HCPCS code A4461 is the #5,400 most-billed Medicaid procedure code, with $208K in payments across 11K claims from 2018–2024. The national median cost per claim is $22.84.

Total Paid

$208K

0.00% of all spending

Total Claims

11K

Providers

6

Avg Cost/Claim

$20

National Cost Distribution

How much do providers bill per claim for A4461? Based on 3 providers billing this code nationally.

Median

$22.84

Average

$17.46

Std Dev

$13.78

Max

$27.74

Percentile Distribution (Cost per Claim)

p10
$6.01
p25
$12.32
Median
$22.84
p75
$25.29
p90
$26.76
p95
$27.25
p99
$27.64

50% of providers bill between $12.32 and $25.29 per claim for this code.

90% bill between $6.01 and $26.76.

Top 1% bill above $27.64.

About This Procedure

HCPCS code A4461 was billed by 6 providers across 11K claims, totaling $208K in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$22.84

Providers Billing

3

National Spending

$208K

Avg/Median Ratio

0.76×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A4461

#ProviderTotal Paid
11891912432$198K
21801929757$9K
3Riverside University Health Systems - Medical Center

Moreno Valley, CA · General Acute Care Hospital

$1K
41700886322$0
51477561983$0
6Arkansas Childrens Hospital

Little Rock, AR · Clinic/Center, Critical Access Hospital

$0

Showing top 6 of 6 providers billing this code