A4605
HCPCS Procedure Code
HCPCS code A4605 is the #1,002 most-billed Medicaid procedure code, with $49.0M in payments across 212K claims from 2018–2024. The national median cost per claim is $121.51. Costs vary widely — the 90th percentile is $356.40 per claim, 2.9× the median.
Total Paid
$49.0M
0.00% of all spending
Total Claims
212K
Providers
152
Avg Cost/Claim
$231
National Cost Distribution
How much do providers bill per claim for A4605? Based on 151 providers billing this code nationally.
Median
$121.51
Average
$167.03
Std Dev
$172.65
Max
$1,671.86
Percentile Distribution (Cost per Claim)
50% of providers bill between $67.50 and $222.59 per claim for this code.
90% bill between $35.99 and $356.40.
Top 1% bill above $527.00.
About This Procedure
HCPCS code A4605 was billed by 152 providers across 212K claims, totaling $49.0M in Medicaid payments from 2018–2024. This code was used for 184K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$121.51
Providers Billing
151
National Spending
$49.0M
Avg/Median Ratio
1.37×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for A4605
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1326607011 | $9.9M |
| 2 | Super Care Inc City Of Industry, CA · Durable Medical Equipment & Medical Supplies | $6.3M |
| 3 | 1902137409 | $5.1M |
| 4 | Apple Homecare Medical Supply Llc Richardson, TX · Durable Medical Equipment & Medical Supplies, Customized Equipment | $2.2M |
| 5 | Pediatric Home Respiratory Services Llc Roseville, MN · Home Health | $1.7M |
| 6 | 1912923301 | $1.6M |
| 7 | 1013915933 | $1.3M |
| 8 | 1922103142 | $1.3M |
| 9 | 1083615991 | $1.1M |
| 10 | 1649228909 | $829K |
| 11 | 1477748119 | $671K |
| 12 | 1013952613 | $666K |
| 13 | 1093873598 | $664K |
| 14 | 1528037538 | $653K |
| 15 | 1538128293 | $590K |
| 16 | 1801866173 | $577K |
| 17 | 1063452829 | $523K |
| 18 | 1366747800 | $513K |
| 19 | 1750608147 | $459K |
| 20 | 1073692794 | $455K |
Showing top 20 of 152 providers billing this code