#2581 of 11K

A5121

HCPCS Procedure Code

HCPCS code A5121 is the #2,581 most-billed Medicaid procedure code, with $4.9M in payments across 77K claims from 2018–2024. The national median cost per claim is $66.46.

Total Paid

$4.9M

0.00% of all spending

Total Claims

77K

Providers

Avg Cost/Claim

$63

National Cost Distribution

How much do providers bill per claim for A5121? Based on 39 providers billing this code nationally.

Median

$66.46

Average

$87.71

Std Dev

$92.65

Max

$562.55

Percentile Distribution (Cost per Claim)

p10

$39.44

p25

$49.69

Median

$66.46

p75

$79.76

p90

$115.59

p95

$159.12

p99

$475.64

50% of providers bill between $49.69 and $79.76 per claim for this code.

90% bill between $39.44 and $115.59.

Top 1% bill above $475.64.

About This Procedure

HCPCS code A5121 was billed by 40 providers across 77K claims, totaling $4.9M in Medicaid payments from 2018–2024. This code was used for 67K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$66.46

Providers Billing

National Spending

$4.9M

Avg/Median Ratio

1.32×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A5121

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$822K	$57.46	0.9× median	Below Median
2	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$576K	$58.96	0.9× median	Below Median
3	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$403K	$111.52	1.7× median	Above 75th
4	1992891238	$378K	$49.01	0.7× median	Below Median
5	1609024397	$310K	$82.34	1.2× median	Above 75th
6	1649244138	$256K	$39.87	0.6× median	Below Median
7	1710932173	$236K	$78.61	1.2× median	Above Median
8	Byram Healthcare Centers, Inc. Portland, OR · Durable Medical Equipment & Medical Supplies	$180K	$78.98	1.2× median	Above Median
9	1346295953	$164K	$61.32	0.9× median	Below Median
10	1427139641	$143K	$78.85	1.2× median	Above Median
11	1881698439	$122K	$46.48	0.7× median	Below Median
12	1023063641	$113K	$75.28	1.1× median	Above Median
13	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$112K	$139.71	2.1× median	Top 10%
14	1235430349	$104K	$131.90	2.0× median	Top 10%
15	1023438538	$100K	$65.95	1.0× median	Below Median
16	1568083087	$97K	$50.37	0.8× median	Below Median
17	1275851800	$93K	$56.86	0.9× median	Below Median
18	1295800068	$80K	$46.96	0.7× median	Below Median
19	1922006741	$77K	$106.51	1.6× median	Above 75th
20	1912952375	$66K	$67.70	1.0× median	Above Median

Showing top 20 of 40 providers billing this code

Related Procedures

A5120$35.7M A5126$1.1M A5122$770K A5131$757K A5112$348K

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