#1891 of 11K

A5057

HCPCS Procedure Code

HCPCS code A5057 is the #1,891 most-billed Medicaid procedure code, with $12.1M in payments across 97K claims from 2018–2024. The national median cost per claim is $118.12. Costs vary widely — the 90th percentile is $242.53 per claim, 2.1× the median.

Total Paid

$12.1M

0.00% of all spending

Total Claims

97K

Providers

Avg Cost/Claim

$124

National Cost Distribution

How much do providers bill per claim for A5057? Based on 59 providers billing this code nationally.

Median

$118.12

Average

$128.66

Std Dev

$78.36

Max

$385.54

Percentile Distribution (Cost per Claim)

p10

$52.39

p25

$74.58

Median

$118.12

p75

$155.57

p90

$242.53

p95

$279.59

p99

$339.34

50% of providers bill between $74.58 and $155.57 per claim for this code.

90% bill between $52.39 and $242.53.

Top 1% bill above $339.34.

About This Procedure

HCPCS code A5057 was billed by 59 providers across 97K claims, totaling $12.1M in Medicaid payments from 2018–2024. This code was used for 84K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$118.12

Providers Billing

National Spending

$12.1M

Avg/Median Ratio

1.09×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A5057

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$2.5M	$115.18	1.0× median	Below Median
2	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$1.3M	$278.88	2.4× median	Top 10%
3	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$1.2M	$180.57	1.5× median	Above 75th
4	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$825K	$95.69	0.8× median	Below Median
5	Byram Healthcare Centers, Inc. Portland, OR · Durable Medical Equipment & Medical Supplies	$544K	$120.84	1.0× median	Above Median
6	1609024397	$499K	$119.05	1.0× median	Above Median
7	1922006741	$460K	$165.84	1.4× median	Above 75th
8	1710932173	$433K	$153.60	1.3× median	Above Median
9	1992891238	$421K	$102.03	0.9× median	Below Median
10	1346295953	$401K	$122.03	1.0× median	Above Median
11	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$290K	$88.34	0.7× median	Below Median
12	1427139641	$265K	$102.41	0.9× median	Below Median
13	1881698439	$256K	$94.48	0.8× median	Below Median
14	1023063641	$255K	$153.51	1.3× median	Above Median
15	1649244138	$206K	$71.98	0.6× median	Below Median
16	1386672988	$179K	$285.92	2.4× median	Top 10%
17	180 Medical Inc Oklahoma City, OK · Durable Medical Equipment & Medical Supplies, Customized Equipment	$170K	$99.92	0.8× median	Below Median
18	Integra Partners Llc Troy, MI · Orthotic Fitter	$143K	$128.43	1.1× median	Above Median
19	1700089653	$130K	$106.14	0.9× median	Below Median
20	1477534717	$130K	$73.71	0.6× median	Below Median

Showing top 20 of 59 providers billing this code

Related Procedures

A5063$14.7M A5061$6.8M A5056Ostomy skin barrier, without flange, each$6.4M A5054$1.5M A5062$251K

← All procedures Top providers →