Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1126 of 11K

A4649

Surgical supply, miscellaneous, not otherwise classified

Surgical supply, miscellaneous, not otherwise classified is the #1,126 most-billed Medicaid procedure code, with $39.2M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $5.04. Costs vary widely — the 90th percentile is $130.30 per claim, 25.9× the median.

Total Paid

$39.2M

0.00% of all spending

Total Claims

1.1M

Providers

514

Avg Cost/Claim

$35

National Cost Distribution

How much do providers bill per claim for A4649? Based on 372 providers billing this code nationally.

Median

$5.04

Average

$47.37

Std Dev

$148.12

Max

$1,936.48

Percentile Distribution (Cost per Claim)

p10
$0.18
p25
$0.96
Median
$5.04
p75
$22.15
p90
$130.30
p95
$228.50
p99
$605.46

50% of providers bill between $0.96 and $22.15 per claim for this code.

90% bill between $0.18 and $130.30.

Top 1% bill above $605.46.

About This Procedure

HCPCS code A4649 (Surgical supply, miscellaneous, not otherwise classified) was billed by 514 providers across 1.1M claims, totaling $39.2M in Medicaid payments from 2018–2024. This code was used for 744K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.04

Providers Billing

372

National Spending

$39.2M

Avg/Median Ratio

9.40×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A4649

#ProviderTotal Paid
11215903547$6.0M
21013981554$5.7M
31073665360$5.4M
41306890389$3.3M
5County Of Ventura

Ventura, CA · Clinic/Center, Emergency Care

$2.4M
61194877332$1.6M
7H & H Drug Stores, Inc

Glendale, CA · Durable Medical Equipment & Medical Supplies

$926K
8J & B Medical Supply Co Inc

Wixom, MI · Durable Medical Equipment & Medical Supplies

$922K
91154523561$810K
101013911056$790K
111073680799$765K
121548354038$735K
13Childrens Hospital Of Philadelphia

Philadelphia, PA · General Acute Care Hospital Children

$697K
14Riverside University Health Systems - Medical Center

Moreno Valley, CA · General Acute Care Hospital

$646K
151215903018$584K
161902137409$457K
171942265939$449K
181417959701$435K
191457381782$382K
201013961408$372K

Showing top 20 of 514 providers billing this code