A4616
HCPCS Procedure Code
HCPCS code A4616 is the #6,186 most-billed Medicaid procedure code, with $86K in payments across 49K claims from 2018–2024. The national median cost per claim is $0.23. Costs vary widely — the 90th percentile is $4.90 per claim, 21.3× the median.
Total Paid
$86K
0.00% of all spending
Total Claims
49K
Providers
94
Avg Cost/Claim
$2
National Cost Distribution
How much do providers bill per claim for A4616? Based on 73 providers billing this code nationally.
Median
$0.23
Average
$2.24
Std Dev
$5.45
Max
$32.93
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.05 and $1.56 per claim for this code.
90% bill between $0.02 and $4.90.
Top 1% bill above $29.25.
About This Procedure
HCPCS code A4616 was billed by 94 providers across 49K claims, totaling $86K in Medicaid payments from 2018–2024. This code was used for 41K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$0.23
Providers Billing
73
National Spending
$86K
Avg/Median Ratio
9.74×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for A4616
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1689904146 | $16K |
| 2 | 1912908773 | $11K |
| 3 | 1104912732 | $11K |
| 4 | 1467879718 | $8K |
| 5 | 1780625533 | $7K |
| 6 | 1861480048 | $7K |
| 7 | 1992850689 | $5K |
| 8 | 1154412476 | $4K |
| 9 | 1811990302 | $3K |
| 10 | Total Longterm Care Inc. Aurora, CO · PACE Provider Organization | $2K |
| 11 | 1013915933 | $2K |
| 12 | 1760513923 | $2K |
| 13 | 1306961792 | $2K |
| 14 | 1346347374 | $1K |
| 15 | 1528205218 | $804 |
| 16 | 1730184649 | $677 |
| 17 | 1346419710 | $420 |
| 18 | 1477748119 | $413 |
| 19 | 1386688414 | $401 |
| 20 | Los Ninos Hospital Inc Phoenix, AZ · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | $385 |
Showing top 20 of 94 providers billing this code