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#6428 of 11K

A4626

HCPCS Procedure Code

HCPCS code A4626 is the #6,428 most-billed Medicaid procedure code, with $66K in payments across 11K claims from 2018–2024. The national median cost per claim is $0.60. Costs vary widely — the 90th percentile is $6.44 per claim, 10.7× the median.

Total Paid

$66K

0.00% of all spending

Total Claims

11K

Providers

10

Avg Cost/Claim

$6

National Cost Distribution

How much do providers bill per claim for A4626? Based on 10 providers billing this code nationally.

Median

$0.60

Average

$2.62

Std Dev

$4.30

Max

$13.63

Percentile Distribution (Cost per Claim)

p10
$0.09
p25
$0.15
Median
$0.60
p75
$3.22
p90
$6.44
p95
$10.03
p99
$12.91

50% of providers bill between $0.15 and $3.22 per claim for this code.

90% bill between $0.09 and $6.44.

Top 1% bill above $12.91.

About This Procedure

HCPCS code A4626 was billed by 10 providers across 11K claims, totaling $66K in Medicaid payments from 2018–2024. This code was used for 8,528 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.60

Providers Billing

10

National Spending

$66K

Avg/Median Ratio

4.37×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A4626

#ProviderTotal Paid
11962452755$52K
21033289889$13K
31851328157$708
41962515783$356
51164612040$86
61033436746$31
71043247448$21
81134782964$15
9Pediatric Home Respiratory Services Llc

Roseville, MN · Home Health

$3
101295823508$0

Showing top 10 of 10 providers billing this code