#2928 of 11K

A4928

HCPCS Procedure Code

HCPCS code A4928 is the #2,928 most-billed Medicaid procedure code, with $3.0M in payments across 64K claims from 2018–2024. The national median cost per claim is $12.07. Costs vary widely — the 90th percentile is $110.83 per claim, 9.2× the median.

Total Paid

$3.0M

0.00% of all spending

Total Claims

64K

Providers

Avg Cost/Claim

$47

National Cost Distribution

How much do providers bill per claim for A4928? Based on 36 providers billing this code nationally.

Median

$12.07

Average

$28.03

Std Dev

$44.31

Max

$156.58

Percentile Distribution (Cost per Claim)

p10

$0.32

p25

$1.15

Median

$12.07

p75

$19.70

p90

$110.83

p95

$136.77

p99

$149.76

50% of providers bill between $1.15 and $19.70 per claim for this code.

90% bill between $0.32 and $110.83.

Top 1% bill above $149.76.

About This Procedure

HCPCS code A4928 was billed by 56 providers across 64K claims, totaling $3.0M in Medicaid payments from 2018–2024. This code was used for 59K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.07

Providers Billing

National Spending

$3.0M

Avg/Median Ratio

2.32×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A4928

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1104811629	$1.8M	$156.58	13.0× median	Top 1%
2	1497841704	$588K	$137.10	11.4× median	Top 10%
3	1467432690	$201K	$136.66	11.3× median	Top 10%
4	1144207911	$116K	$17.48	1.4× median	Above Median
5	1437171949	$62K	$59.29	4.9× median	Above 75th
6	1972550028	$58K	$25.68	2.1× median	Above 75th
7	1265460901	$45K	$86.80	7.2× median	Above 75th
8	1396834321	$40K	$17.54	1.5× median	Above Median
9	1316123870	$21K	$17.55	1.5× median	Above Median
10	1871044891	$16K	$7.59	0.6× median	Below Median
11	1922139104	$15K	$11.60	1.0× median	Below Median
12	Healthkeeperz, Inc Pembroke, NC · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$12K	$17.73	1.5× median	Above Median
13	1144603010	$12K	$25.62	2.1× median	Above 75th
14	1902897259	$10K	$134.86	11.2× median	Top 10%
15	1386875714	$8K	$15.99	1.3× median	Above Median
16	1821531922	$6K	$11.88	1.0× median	Below Median
17	1922071034	$5K	$15.42	1.3× median	Above Median
18	1134672066	$5K	$11.24	0.9× median	Below Median
19	1174847586	$3K	$39.31	3.3× median	Above 75th
20	1083976823	$2K	$6.73	0.6× median	Below Median

Showing top 20 of 56 providers billing this code

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