#2229 of 11K

A4553

HCPCS Procedure Code

HCPCS code A4553 is the #2,229 most-billed Medicaid procedure code, with $7.6M in payments across 366K claims from 2018–2024. The national median cost per claim is $15.13. Costs vary widely — the 90th percentile is $48.18 per claim, 3.2× the median.

Total Paid

$7.6M

0.00% of all spending

Total Claims

366K

Providers

Avg Cost/Claim

$21

National Cost Distribution

How much do providers bill per claim for A4553? Based on 74 providers billing this code nationally.

Median

$15.13

Average

$25.65

Std Dev

$32.64

Max

$221.58

Percentile Distribution (Cost per Claim)

p10

$11.46

p25

$14.10

Median

$15.13

p75

$27.78

p90

$48.18

p95

$58.36

p99

$187.86

50% of providers bill between $14.10 and $27.78 per claim for this code.

90% bill between $11.46 and $48.18.

Top 1% bill above $187.86.

About This Procedure

HCPCS code A4553 was billed by 75 providers across 366K claims, totaling $7.6M in Medicaid payments from 2018–2024. This code was used for 341K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$15.13

Providers Billing

National Spending

$7.6M

Avg/Median Ratio

1.70×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A4553

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1033190137	$1.1M	$175.39	11.6× median	Top 10%
2	1386699221	$738K	$15.36	1.0× median	Above Median
3	1922071034	$513K	$35.66	2.4× median	Above 75th
4	1568851129	$484K	$14.48	1.0× median	Below Median
5	B.w.medical Supply Co.,inc. Baltimore, MD · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$445K	$15.33	1.0× median	Above Median
6	1043215106	$438K	$35.99	2.4× median	Above 75th
7	1174526792	$431K	$14.92	1.0× median	Below Median
8	1417998345	$287K	$15.06	1.0× median	Below Median
9	1407888175	$265K	$14.76	1.0× median	Below Median
10	1164944641	$263K	$35.39	2.3× median	Above 75th
11	Shield Denver Health Care Center Inc Aurora, CO · Durable Medical Equipment & Medical Supplies	$254K	$17.13	1.1× median	Above Median
12	Ease-e Medical Inc. Canon City, CO · Durable Medical Equipment & Medical Supplies	$245K	$55.44	3.7× median	Top 10%
13	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$193K	$12.25	0.8× median	Below Median
14	1992809586	$158K	$14.13	0.9× median	Below Median
15	1922054915	$145K	$14.09	0.9× median	Below Median
16	1114978731	$143K	$15.18	1.0× median	Above Median
17	1831649573	$123K	$14.61	1.0× median	Below Median
18	1316364011	$119K	$50.23	3.3× median	Top 10%
19	1780868224	$104K	$61.08	4.0× median	Top 10%
20	1720033913	$102K	$15.08	1.0× median	Below Median

Showing top 20 of 75 providers billing this code

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