#2864 of 11K

A5514

HCPCS Procedure Code

HCPCS code A5514 is the #2,864 most-billed Medicaid procedure code, with $3.3M in payments across 97K claims from 2018–2024. The national median cost per claim is $32.49. Costs vary widely — the 90th percentile is $90.77 per claim, 2.8× the median.

Total Paid

$3.3M

0.00% of all spending

Total Claims

97K

Providers

162

Avg Cost/Claim

$34

National Cost Distribution

How much do providers bill per claim for A5514? Based on 156 providers billing this code nationally.

Median

$32.49

Average

$44.31

Std Dev

$42.02

Max

$307.63

Percentile Distribution (Cost per Claim)

p10

$12.75

p25

$19.58

Median

$32.49

p75

$53.55

p90

$90.77

p95

$110.21

p99

$224.43

50% of providers bill between $19.58 and $53.55 per claim for this code.

90% bill between $12.75 and $90.77.

Top 1% bill above $224.43.

About This Procedure

HCPCS code A5514 was billed by 162 providers across 97K claims, totaling $3.3M in Medicaid payments from 2018–2024. This code was used for 51K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$32.49

Providers Billing

156

National Spending

$3.3M

Avg/Median Ratio

1.36×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A5514

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1104800440	$518K	$39.78	1.2× median	Above Median
2	1558316851	$234K	$16.57	0.5× median	Below Median
3	1174573307	$222K	$47.90	1.5× median	Above Median
4	1356372221	$176K	$103.41	3.2× median	Top 10%
5	1952679052	$123K	$74.96	2.3× median	Above 75th
6	1588148134	$110K	$94.54	2.9× median	Top 10%
7	1487784948	$70K	$21.46	0.7× median	Below Median
8	1235310343	$66K	$15.18	0.5× median	Below Median
9	1629015904	$64K	$26.68	0.8× median	Below Median
10	1730284472	$62K	$41.81	1.3× median	Above Median
11	1043364003	$62K	$18.21	0.6× median	Below Median
12	1689665911	$62K	$72.20	2.2× median	Above 75th
13	1578557021	$60K	$111.56	3.4× median	Top 10%
14	1740337427	$60K	$27.34	0.8× median	Below Median
15	1669546701	$53K	$92.82	2.9× median	Top 10%
16	1487757050	$53K	$21.46	0.7× median	Below Median
17	1003980152	$51K	$105.60	3.3× median	Top 10%
18	1033212600	$50K	$20.27	0.6× median	Below Median
19	1578522389	$50K	$53.80	1.7× median	Above 75th
20	1679625560	$47K	$46.51	1.4× median	Above Median

Showing top 20 of 162 providers billing this code

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