#1577 of 11K

A4627

HCPCS Procedure Code

HCPCS code A4627 is the #1,577 most-billed Medicaid procedure code, with $18.6M in payments across 709K claims from 2018–2024. The national median cost per claim is $21.89. Costs vary widely — the 90th percentile is $44.48 per claim, 2.0× the median.

Total Paid

$18.6M

0.00% of all spending

Total Claims

709K

Providers

463

Avg Cost/Claim

$26

National Cost Distribution

How much do providers bill per claim for A4627? Based on 433 providers billing this code nationally.

Median

$21.89

Average

$23.56

Std Dev

$14.94

Max

$74.71

Percentile Distribution (Cost per Claim)

p10

$6.86

p25

$11.61

Median

$21.89

p75

$33.05

p90

$44.48

p95

$55.85

p99

$60.42

50% of providers bill between $11.61 and $33.05 per claim for this code.

90% bill between $6.86 and $44.48.

Top 1% bill above $60.42.

About This Procedure

HCPCS code A4627 was billed by 463 providers across 709K claims, totaling $18.6M in Medicaid payments from 2018–2024. This code was used for 645K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$21.89

Providers Billing

433

National Spending

$18.6M

Avg/Median Ratio

1.08×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A4627

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1003813064	$2.6M	$49.47	2.3× median	Top 10%
2	Aeroflow Inc Arden, NC · Durable Medical Equipment & Medical Supplies	$1.2M	$32.22	1.5× median	Above Median
3	1598898991	$1.2M	$33.74	1.5× median	Above 75th
4	1669415394	$1.1M	$22.82	1.0× median	Above Median
5	1336197482	$869K	$31.77	1.5× median	Above Median
6	1750608147	$687K	$24.09	1.1× median	Above Median
7	1497707426	$621K	$23.77	1.1× median	Above Median
8	1740671320	$597K	$34.59	1.6× median	Above 75th
9	1871551903	$576K	$19.39	0.9× median	Below Median
10	1326140138	$534K	$41.69	1.9× median	Above 75th
11	1801866173	$458K	$30.64	1.4× median	Above Median
12	1285611012	$454K	$30.57	1.4× median	Above Median
13	1639102072	$449K	$12.64	0.6× median	Below Median
14	1760577159	$319K	$19.94	0.9× median	Below Median
15	1659424992	$303K	$20.50	0.9× median	Below Median
16	1689665911	$288K	$26.85	1.2× median	Above Median
17	1174189625	$263K	$27.40	1.3× median	Above Median
18	1477801439	$251K	$41.96	1.9× median	Above 75th
19	1043317761	$246K	$25.66	1.2× median	Above Median
20	1023278926	$235K	$27.35	1.2× median	Above Median

Showing top 20 of 463 providers billing this code

Related Procedures

A4624$98.4M A4629$33.3M A4623$20.0M A4628$11.7M A4630$1.8M

← All procedures Top providers →