A6196
HCPCS Procedure Code
HCPCS code A6196 is the #1,150 most-billed Medicaid procedure code, with $36.9M in payments across 696K claims from 2018–2024. The national median cost per claim is $71.68. Costs vary widely — the 90th percentile is $159.25 per claim, 2.2× the median.
Total Paid
$36.9M
0.00% of all spending
Total Claims
696K
Providers
215
Avg Cost/Claim
$53
National Cost Distribution
How much do providers bill per claim for A6196? Based on 199 providers billing this code nationally.
Median
$71.68
Average
$80.19
Std Dev
$64.95
Max
$432.25
Percentile Distribution (Cost per Claim)
50% of providers bill between $28.52 and $118.97 per claim for this code.
90% bill between $7.98 and $159.25.
Top 1% bill above $241.48.
About This Procedure
HCPCS code A6196 was billed by 215 providers across 696K claims, totaling $36.9M in Medicaid payments from 2018–2024. This code was used for 586K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$71.68
Providers Billing
199
National Spending
$36.9M
Avg/Median Ratio
1.12×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for A6196
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1548367063 | $5.0M |
| 2 | 1013124213 | $4.9M |
| 3 | Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies | $2.8M |
| 4 | Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies | $1.8M |
| 5 | Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies | $1.5M |
| 6 | 1023054871 | $1.4M |
| 7 | Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies | $935K |
| 8 | 1730397175 | $905K |
| 9 | 1073776225 | $902K |
| 10 | 1295800068 | $733K |
| 11 | 1710932173 | $709K |
| 12 | 1649244138 | $699K |
| 13 | 1023438538 | $644K |
| 14 | 1275703084 | $631K |
| 15 | 1376916379 | $603K |
| 16 | 1710452701 | $527K |
| 17 | 1730174764 | $512K |
| 18 | Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier | $510K |
| 19 | 1962515783 | $508K |
| 20 | 1427139641 | $482K |
Showing top 20 of 215 providers billing this code