A5131
HCPCS Procedure Code
HCPCS code A5131 is the #4,199 most-billed Medicaid procedure code, with $757K in payments across 68K claims from 2018–2024. The national median cost per claim is $7.99. Costs vary widely — the 90th percentile is $16.57 per claim, 2.1× the median.
Total Paid
$757K
0.00% of all spending
Total Claims
68K
Providers
44
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for A5131? Based on 44 providers billing this code nationally.
Median
$7.99
Average
$10.11
Std Dev
$6.61
Max
$36.32
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.32 and $12.57 per claim for this code.
90% bill between $4.42 and $16.57.
Top 1% bill above $31.02.
About This Procedure
HCPCS code A5131 was billed by 44 providers across 68K claims, totaling $757K in Medicaid payments from 2018–2024. This code was used for 60K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$7.99
Providers Billing
44
National Spending
$757K
Avg/Median Ratio
1.27×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for A5131
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1164403903 | $144K |
| 2 | 1639231483 | $93K |
| 3 | 1942487608 | $76K |
| 4 | 1700958857 | $49K |
| 5 | 1114267127 | $47K |
| 6 | 1760913677 | $42K |
| 7 | 1841286556 | $26K |
| 8 | 1922006741 | $24K |
| 9 | 1215096318 | $24K |
| 10 | 1114446762 | $22K |
| 11 | 1457310849 | $20K |
| 12 | Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier | $18K |
| 13 | 1801899414 | $16K |
| 14 | 1013124213 | $13K |
| 15 | Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies | $10K |
| 16 | Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies | $10K |
| 17 | 1013952613 | $9K |
| 18 | 1962432666 | $9K |
| 19 | 1205976438 | $8K |
| 20 | 1134120462 | $8K |
Showing top 20 of 44 providers billing this code