#1131 of 11K

A6021

HCPCS Procedure Code

HCPCS code A6021 is the #1,131 most-billed Medicaid procedure code, with $38.9M in payments across 302K claims from 2018–2024. The national median cost per claim is $111.06. Costs vary widely — the 90th percentile is $273.64 per claim, 2.5× the median.

Total Paid

$38.9M

0.00% of all spending

Total Claims

302K

Providers

159

Avg Cost/Claim

$129

National Cost Distribution

How much do providers bill per claim for A6021? Based on 143 providers billing this code nationally.

Median

$111.06

Average

$137.83

Std Dev

$129.83

Max

$717.73

Percentile Distribution (Cost per Claim)

p10

$4.04

p25

$31.33

Median

$111.06

p75

$212.32

p90

$273.64

p95

$412.68

p99

$556.40

50% of providers bill between $31.33 and $212.32 per claim for this code.

90% bill between $4.04 and $273.64.

Top 1% bill above $556.40.

About This Procedure

HCPCS code A6021 was billed by 159 providers across 302K claims, totaling $38.9M in Medicaid payments from 2018–2024. This code was used for 256K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$111.06

Providers Billing

143

National Spending

$38.9M

Avg/Median Ratio

1.24×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A6021

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1548367063	$5.3M	$134.58	1.2× median	Above Median
2	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$4.9M	$198.50	1.8× median	Above Median
3	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$2.2M	$277.19	2.5× median	Top 10%
4	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$1.9M	$221.13	2.0× median	Above 75th
5	1013124213	$1.5M	$37.90	0.3× median	Below Median
6	1023054871	$1.4M	$305.40	2.7× median	Top 10%
7	1073776225	$1.4M	$258.64	2.3× median	Above 75th
8	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$1.4M	$222.74	2.0× median	Above 75th
9	1679653356	$948K	$318.65	2.9× median	Top 10%
10	1649244138	$838K	$92.30	0.8× median	Below Median
11	1275703084	$801K	$233.58	2.1× median	Above 75th
12	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$797K	$163.89	1.5× median	Above Median
13	1710932173	$749K	$133.69	1.2× median	Above Median
14	1295800068	$731K	$238.16	2.1× median	Above 75th
15	1376916379	$724K	$98.82	0.9× median	Below Median
16	1962515783	$718K	$91.78	0.8× median	Below Median
17	1346295953	$715K	$203.52	1.8× median	Above Median
18	1427139641	$710K	$237.41	2.1× median	Above 75th
19	1710452701	$673K	$47.29	0.4× median	Below Median
20	1730174764	$587K	$114.51	1.0× median	Above Median

Showing top 20 of 159 providers billing this code

Related Procedures

A6023$4.0M A6022$1.4M A6025$46K A6011$26K A6024$0

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