#2459 of 11K

A4930

HCPCS Procedure Code

HCPCS code A4930 is the #2,459 most-billed Medicaid procedure code, with $5.7M in payments across 247K claims from 2018–2024. The national median cost per claim is $3.61. Costs vary widely — the 90th percentile is $68.16 per claim, 18.9× the median.

Total Paid

$5.7M

0.00% of all spending

Total Claims

247K

Providers

179

Avg Cost/Claim

$23

National Cost Distribution

How much do providers bill per claim for A4930? Based on 150 providers billing this code nationally.

Median

$3.61

Average

$22.46

Std Dev

$38.25

Max

$258.82

Percentile Distribution (Cost per Claim)

p10

$0.02

p25

$0.16

Median

$3.61

p75

$31.64

p90

$68.16

p95

$103.48

p99

$155.02

50% of providers bill between $0.16 and $31.64 per claim for this code.

90% bill between $0.02 and $68.16.

Top 1% bill above $155.02.

About This Procedure

HCPCS code A4930 was billed by 179 providers across 247K claims, totaling $5.7M in Medicaid payments from 2018–2024. This code was used for 204K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3.61

Providers Billing

150

National Spending

$5.7M

Avg/Median Ratio

6.22×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A4930

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Aeroflow Inc Arden, NC · Durable Medical Equipment & Medical Supplies	$2.3M	$103.36	28.6× median	Top 10%
2	1013119080	$1.3M	$154.89	42.9× median	Top 10%
3	1780739383	$340K	$155.15	43.0× median	Top 1%
4	1538128293	$283K	$36.31	10.1× median	Above 75th
5	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$151K	$25.28	7.0× median	Above Median
6	1912945940	$98K	$25.92	7.2× median	Above Median
7	1598157778	$91K	$50.98	14.1× median	Above 75th
8	1740242262	$76K	$31.03	8.6× median	Above Median
9	1578999553	$69K	$42.36	11.7× median	Above 75th
10	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$66K	$20.51	5.7× median	Above Median
11	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$62K	$22.19	6.1× median	Above Median
12	1265460901	$60K	$70.43	19.5× median	Top 10%
13	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$60K	$84.29	23.3× median	Top 10%
14	1275612673	$52K	$13.27	3.7× median	Above Median
15	Byram Healthcare Centers, Inc. Portland, OR · Durable Medical Equipment & Medical Supplies	$48K	$41.44	11.5× median	Above 75th
16	1346646882	$45K	$73.48	20.4× median	Top 10%
17	1699853713	$43K	$6.58	1.8× median	Above Median
18	1295259612	$36K	$129.94	36.0× median	Top 10%
19	1861480048	$34K	$67.91	18.8× median	Above 75th
20	1659425726	$24K	$39.27	10.9× median	Above 75th

Showing top 20 of 179 providers billing this code

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