#813 of 11K

A4520

HCPCS Procedure Code

HCPCS code A4520 is the #813 most-billed Medicaid procedure code, with $74.3M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $39.60. Costs vary widely — the 90th percentile is $128.44 per claim, 3.2× the median.

Total Paid

$74.3M

0.01% of all spending

Total Claims

1.1M

Providers

277

Avg Cost/Claim

$67

National Cost Distribution

How much do providers bill per claim for A4520? Based on 222 providers billing this code nationally.

Median

$39.60

Average

$60.68

Std Dev

$66.82

Max

$485.86

Percentile Distribution (Cost per Claim)

p10

$0.99

p25

$9.95

Median

$39.60

p75

$98.89

p90

$128.44

p95

$160.77

p99

$277.88

50% of providers bill between $9.95 and $98.89 per claim for this code.

90% bill between $0.99 and $128.44.

Top 1% bill above $277.88.

About This Procedure

HCPCS code A4520 was billed by 277 providers across 1.1M claims, totaling $74.3M in Medicaid payments from 2018–2024. This code was used for 962K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$39.60

Providers Billing

222

National Spending

$74.3M

Avg/Median Ratio

1.53×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A4520

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1710915723	$30.9M	$107.59	2.7× median	Above 75th
2	Aeroflow Inc Arden, NC · Durable Medical Equipment & Medical Supplies	$6.2M	$87.17	2.2× median	Above Median
3	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$3.4M	$33.98	0.9× median	Below Median
4	1962460766	$2.2M	$119.46	3.0× median	Above 75th
5	Activstyle, Llc Saint Paul, MN · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition	$2.0M	$45.48	1.1× median	Above Median
6	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$1.5M	$46.63	1.2× median	Above Median
7	1467879718	$1.4M	$485.86	12.3× median	Top 1%
8	1750895975	$1.3M	$282.88	7.1× median	Top 1%
9	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$1.3M	$22.26	0.6× median	Below Median
10	1255591806	$1.3M	$386.53	9.8× median	Top 1%
11	1194047613	$1.2M	$48.69	1.2× median	Above Median
12	Integra Partners Llc Troy, MI · Orthotic Fitter	$1.1M	$85.70	2.2× median	Above Median
13	1962481697	$1.0M	$116.53	2.9× median	Above 75th
14	1194807297	$938K	$78.18	2.0× median	Above Median
15	1174526792	$859K	$160.08	4.0× median	Top 10%
16	1770527590	$789K	$98.98	2.5× median	Above 75th
17	1437159464	$755K	$113.29	2.9× median	Above 75th
18	1588760870	$702K	$229.89	5.8× median	Top 10%
19	1578736476	$614K	$95.74	2.4× median	Above Median
20	1609952423	$595K	$115.25	2.9× median	Above 75th

Showing top 20 of 277 providers billing this code

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