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#4037 of 11K

A4481

HCPCS Procedure Code

HCPCS code A4481 is the #4,037 most-billed Medicaid procedure code, with $910K in payments across 36K claims from 2018–2024. The national median cost per claim is $9.30. Costs vary widely — the 90th percentile is $98.14 per claim, 10.6× the median.

Total Paid

$910K

0.00% of all spending

Total Claims

36K

Providers

25

Avg Cost/Claim

$25

National Cost Distribution

How much do providers bill per claim for A4481? Based on 25 providers billing this code nationally.

Median

$9.30

Average

$32.75

Std Dev

$53.05

Max

$228.11

Percentile Distribution (Cost per Claim)

p10
$1.70
p25
$8.02
Median
$9.30
p75
$18.87
p90
$98.14
p95
$120.03
p99
$203.33

50% of providers bill between $8.02 and $18.87 per claim for this code.

90% bill between $1.70 and $98.14.

Top 1% bill above $203.33.

About This Procedure

HCPCS code A4481 was billed by 25 providers across 36K claims, totaling $910K in Medicaid payments from 2018–2024. This code was used for 31K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.30

Providers Billing

25

National Spending

$910K

Avg/Median Ratio

3.52×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A4481

#ProviderTotal Paid
11902098965$316K
21083615991$224K
3Apple Homecare Medical Supply Llc

Richardson, TX · Durable Medical Equipment & Medical Supplies, Customized Equipment

$73K
41104882638$46K
51316364011$42K
61528037538$31K
71477748119$24K
81013952613$22K
91831499789$20K
101962452755$19K
111245467240$14K
12Integra Partners Llc

Troy, MI · Orthotic Fitter

$13K
131164533014$12K
14Medco Respiratory Instruments, Inc.

Houston, TX · Durable Medical Equipment & Medical Supplies

$11K
151750608147$11K
161073539896$10K
171386800423$8K
181093761611$7K
191992750913$5K
201760573836$509

Showing top 20 of 25 providers billing this code

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