#3864 of 11K

A5200

HCPCS Procedure Code

HCPCS code A5200 is the #3,864 most-billed Medicaid procedure code, with $1.1M in payments across 31K claims from 2018–2024. The national median cost per claim is $27.94. Costs vary widely — the 90th percentile is $58.16 per claim, 2.1× the median.

Total Paid

$1.1M

0.00% of all spending

Total Claims

31K

Providers

Avg Cost/Claim

$34

National Cost Distribution

How much do providers bill per claim for A5200? Based on 35 providers billing this code nationally.

Median

$27.94

Average

$32.80

Std Dev

$24.43

Max

$97.64

Percentile Distribution (Cost per Claim)

p10

$8.98

p25

$15.97

Median

$27.94

p75

$41.17

p90

$58.16

p95

$91.08

p99

$96.87

50% of providers bill between $15.97 and $41.17 per claim for this code.

90% bill between $8.98 and $58.16.

Top 1% bill above $96.87.

About This Procedure

HCPCS code A5200 was billed by 36 providers across 31K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 26K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$27.94

Providers Billing

National Spending

$1.1M

Avg/Median Ratio

1.17×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A5200

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1760425011	$235K	$30.07	1.1× median	Above Median
2	1861480048	$223K	$38.65	1.4× median	Above Median
3	1316364011	$216K	$97.64	3.5× median	Top 1%
4	1306865340	$74K	$32.38	1.2× median	Above Median
5	1467726638	$64K	$30.87	1.1× median	Above Median
6	1215966205	$51K	$41.16	1.5× median	Above Median
7	1013952613	$30K	$18.06	0.6× median	Below Median
8	1710978390	$23K	$48.17	1.7× median	Above 75th
9	1821673369	$22K	$95.38	3.4× median	Top 10%
10	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$19K	$58.46	2.1× median	Top 10%
11	1306961792	$17K	$22.57	0.8× median	Below Median
12	1639161250	$17K	$18.78	0.7× median	Below Median
13	1942246855	$15K	$30.05	1.1× median	Above Median
14	1346295953	$12K	$54.89	2.0× median	Above 75th
15	1457310492	$11K	$41.18	1.5× median	Above 75th
16	1194859629	$7K	$13.77	0.5× median	Below Median
17	1831561091	$7K	$5.30	0.2× median	Below Median
18	1033825427	$6K	$21.93	0.8× median	Below Median
19	Apple Homecare Medical Supply Llc Richardson, TX · Durable Medical Equipment & Medical Supplies, Customized Equipment	$4K	$38.75	1.4× median	Above Median
20	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$4K	$17.44	0.6× median	Below Median

Showing top 20 of 36 providers billing this code

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