#2633 of 11K

A6199

HCPCS Procedure Code

HCPCS code A6199 is the #2,633 most-billed Medicaid procedure code, with $4.4M in payments across 72K claims from 2018–2024. The national median cost per claim is $56.87. Costs vary widely — the 90th percentile is $137.98 per claim, 2.4× the median.

Total Paid

$4.4M

0.00% of all spending

Total Claims

72K

Providers

Avg Cost/Claim

$61

National Cost Distribution

How much do providers bill per claim for A6199? Based on 54 providers billing this code nationally.

Median

$56.87

Average

$69.00

Std Dev

$50.53

Max

$223.34

Percentile Distribution (Cost per Claim)

p10

$9.99

p25

$31.50

Median

$56.87

p75

$97.79

p90

$137.98

p95

$157.59

p99

$196.11

50% of providers bill between $31.50 and $97.79 per claim for this code.

90% bill between $9.99 and $137.98.

Top 1% bill above $196.11.

About This Procedure

HCPCS code A6199 was billed by 57 providers across 72K claims, totaling $4.4M in Medicaid payments from 2018–2024. This code was used for 63K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$56.87

Providers Billing

National Spending

$4.4M

Avg/Median Ratio

1.21×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A6199

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1013124213	$720K	$33.57	0.6× median	Below Median
2	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$555K	$86.09	1.5× median	Above Median
3	1548367063	$458K	$71.20	1.3× median	Above Median
4	1710932173	$260K	$86.23	1.5× median	Above Median
5	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$254K	$153.68	2.7× median	Top 10%
6	1730397175	$250K	$40.41	0.7× median	Below Median
7	1346295953	$236K	$98.03	1.7× median	Above 75th
8	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$233K	$93.93	1.7× median	Above Median
9	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$226K	$114.83	2.0× median	Above 75th
10	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$185K	$97.08	1.7× median	Above Median
11	1649244138	$129K	$40.16	0.7× median	Below Median
12	1427139641	$121K	$119.68	2.1× median	Above 75th
13	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$107K	$51.68	0.9× median	Below Median
14	1730174764	$81K	$89.38	1.6× median	Above Median
15	1023054871	$74K	$90.84	1.6× median	Above Median
16	1023438538	$63K	$74.11	1.3× median	Above Median
17	1225413743	$54K	$137.85	2.4× median	Above 75th
18	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$49K	$159.15	2.8× median	Top 10%
19	1710452701	$45K	$20.20	0.4× median	Below Median
20	1609024397	$44K	$156.75	2.8× median	Top 10%

Showing top 20 of 57 providers billing this code

Related Procedures

A6197$78.7M A6196$36.9M A6209$23.9M A6207$2.1M A6203$1.2M

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