#2887 of 11K

A4913

HCPCS Procedure Code

HCPCS code A4913 is the #2,887 most-billed Medicaid procedure code, with $3.1M in payments across 106K claims from 2018–2024. The national median cost per claim is $13.39. Costs vary widely — the 90th percentile is $141.66 per claim, 10.6× the median.

Total Paid

$3.1M

0.00% of all spending

Total Claims

106K

Providers

Avg Cost/Claim

$30

National Cost Distribution

How much do providers bill per claim for A4913? Based on 41 providers billing this code nationally.

Median

$13.39

Average

$41.33

Std Dev

$59.65

Max

$228.86

Percentile Distribution (Cost per Claim)

p10

$0.05

p25

$2.34

Median

$13.39

p75

$62.56

p90

$141.66

p95

$165.29

p99

$212.04

50% of providers bill between $2.34 and $62.56 per claim for this code.

90% bill between $0.05 and $141.66.

Top 1% bill above $212.04.

About This Procedure

HCPCS code A4913 was billed by 93 providers across 106K claims, totaling $3.1M in Medicaid payments from 2018–2024. This code was used for 23K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.39

Providers Billing

National Spending

$3.1M

Avg/Median Ratio

3.09×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A4913

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1609850320	$1.2M	$65.61	4.9× median	Above 75th
2	1942293691	$1000K	$228.86	17.1× median	Top 1%
3	1003883125	$293K	$165.29	12.3× median	Top 10%
4	Central Florida Kidney Centers Inc Orlando, FL · Clinic/Center End-Stage Renal Disease (ESRD) Treatment	$259K	$126.83	9.5× median	Above 75th
5	1265686182	$105K	$62.56	4.7× median	Above 75th
6	1518196252	$99K	$63.29	4.7× median	Above 75th
7	1720056203	$33K	$154.99	11.6× median	Top 10%
8	1326297078	$22K	$13.39	1.0× median	Above Median
9	1104844562	$20K	$72.26	5.4× median	Above 75th
10	1508834318	$19K	$113.45	8.5× median	Above 75th
11	1174067706	$17K	$7.07	0.5× median	Below Median
12	1831153980	$16K	$7.22	0.5× median	Below Median
13	Laurel Canyon Dialysis Llc Sun Valley, CA · Clinic/Center End-Stage Renal Disease (ESRD) Treatment	$15K	$3.70	0.3× median	Below Median
14	Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital	$14K	$16.26	1.2× median	Above Median
15	1982888202	$9K	$27.40	2.0× median	Above Median
16	1316315955	$7K	$39.08	2.9× median	Above Median
17	1508429267	$4K	$186.81	14.0× median	Top 10%
18	1083087928	$3K	$3.27	0.2× median	Below Median
19	1376859108	$3K	$10.51	0.8× median	Below Median
20	1992700314	$2K	$141.66	10.6× median	Top 10%

Showing top 20 of 93 providers billing this code

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