A4604
HCPCS Procedure Code
HCPCS code A4604 is the #644 most-billed Medicaid procedure code, with $116.4M in payments across 4.7M claims from 2018–2024. The national median cost per claim is $22.01.
Total Paid
$116.4M
0.01% of all spending
Total Claims
4.7M
Providers
2K
Avg Cost/Claim
$25
National Cost Distribution
How much do providers bill per claim for A4604? Based on 2K providers billing this code nationally.
Median
$22.01
Average
$22.04
Std Dev
$13.42
Max
$165.10
Percentile Distribution (Cost per Claim)
50% of providers bill between $11.38 and $30.33 per claim for this code.
90% bill between $5.33 and $39.29.
Top 1% bill above $56.82.
About This Procedure
HCPCS code A4604 was billed by 2K providers across 4.7M claims, totaling $116.4M in Medicaid payments from 2018–2024. This code was used for 4.2M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$22.01
Providers Billing
2K
National Spending
$116.4M
Avg/Median Ratio
1.00×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for A4604
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1396851184 | $3.0M |
| 2 | 1962426122 | $2.4M |
| 3 | Medcare Equipment Company, Llc Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | $2.3M |
| 4 | 1134122047 | $1.7M |
| 5 | 1568465938 | $1.5M |
| 6 | 1134303902 | $1.2M |
| 7 | 1891275590 | $1.2M |
| 8 | Home Medical Equipment Specialists Llc Albuquerque, NM · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | $1.2M |
| 9 | Indiana University Health, Inc Indianapolis, IN · Durable Medical Equipment & Medical Supplies | $1.1M |
| 10 | 1043276819 | $1.1M |
| 11 | 1801129135 | $1.0M |
| 12 | 1730182023 | $1.0M |
| 13 | 1659361947 | $980K |
| 14 | 1972554939 | $967K |
| 15 | 1922046085 | $953K |
| 16 | 1831289826 | $947K |
| 17 | 1689665911 | $938K |
| 18 | 1033142484 | $920K |
| 19 | 1003154352 | $839K |
| 20 | 1417097593 | $783K |
Showing top 20 of 2K providers billing this code