#3802 of 11K

A6203

HCPCS Procedure Code

HCPCS code A6203 is the #3,802 most-billed Medicaid procedure code, with $1.2M in payments across 107K claims from 2018–2024. The national median cost per claim is $11.62. Costs vary widely — the 90th percentile is $45.85 per claim, 3.9× the median.

Total Paid

$1.2M

0.00% of all spending

Total Claims

107K

Providers

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for A6203? Based on 36 providers billing this code nationally.

Median

$11.62

Average

$20.18

Std Dev

$23.55

Max

$114.27

Percentile Distribution (Cost per Claim)

p10

$0.95

p25

$4.61

Median

$11.62

p75

$28.80

p90

$45.85

p95

$56.83

p99

$99.96

50% of providers bill between $4.61 and $28.80 per claim for this code.

90% bill between $0.95 and $45.85.

Top 1% bill above $99.96.

About This Procedure

HCPCS code A6203 was billed by 39 providers across 107K claims, totaling $1.2M in Medicaid payments from 2018–2024. This code was used for 92K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.62

Providers Billing

National Spending

$1.2M

Avg/Median Ratio

1.74×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A6203

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1013124213	$615K	$7.67	0.7× median	Below Median
2	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$135K	$73.38	6.3× median	Top 10%
3	1992162911	$57K	$13.07	1.1× median	Above Median
4	1649244138	$48K	$26.78	2.3× median	Above Median
5	1063771798	$46K	$10.07	0.9× median	Below Median
6	1225413743	$40K	$11.58	1.0× median	Below Median
7	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$36K	$50.40	4.3× median	Top 10%
8	1730174764	$33K	$51.31	4.4× median	Top 10%
9	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$32K	$28.64	2.5× median	Above Median
10	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$30K	$29.29	2.5× median	Above 75th
11	1033436746	$20K	$12.64	1.1× median	Above Median
12	1548367063	$17K	$32.54	2.8× median	Above 75th
13	1730397175	$15K	$7.77	0.7× median	Below Median
14	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$5K	$31.50	2.7× median	Above 75th
15	1700288941	$3K	$17.54	1.5× median	Above Median
16	1710452701	$3K	$7.59	0.7× median	Below Median
17	1801877436	$2K	$7.71	0.7× median	Below Median
18	1710932173	$2K	$31.83	2.7× median	Above 75th
19	1073849667	$2K	$18.15	1.6× median	Above Median
20	1407523400	$2K	$3.82	0.3× median	Below Median

Showing top 20 of 39 providers billing this code

Related Procedures

A6197$78.7M A6212$60.0M A6196$36.9M A6210$34.5M A6209$23.9M

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