A6204
HCPCS Procedure Code
HCPCS code A6204 is the #6,231 most-billed Medicaid procedure code, with $82K in payments across 6K claims from 2018–2024. The national median cost per claim is $10.61. Costs vary widely — the 90th percentile is $56.64 per claim, 5.3× the median.
Total Paid
$82K
0.00% of all spending
Total Claims
6K
Providers
14
Avg Cost/Claim
$13
National Cost Distribution
How much do providers bill per claim for A6204? Based on 12 providers billing this code nationally.
Median
$10.61
Average
$23.14
Std Dev
$24.11
Max
$64.93
Percentile Distribution (Cost per Claim)
50% of providers bill between $4.59 and $40.45 per claim for this code.
90% bill between $2.48 and $56.64.
Top 1% bill above $64.02.
About This Procedure
HCPCS code A6204 was billed by 14 providers across 6K claims, totaling $82K in Medicaid payments from 2018–2024. This code was used for 5K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$10.61
Providers Billing
12
National Spending
$82K
Avg/Median Ratio
2.18×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for A6204
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1013124213 | $59K |
| 2 | Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies | $8K |
| 3 | 1548367063 | $7K |
| 4 | Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies | $3K |
| 5 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $2K |
| 6 | 1225413743 | $992 |
| 7 | 1407523400 | $743 |
| 8 | 1548235302 | $403 |
| 9 | 1821211673 | $380 |
| 10 | 1710452701 | $198 |
| 11 | 1538243308 | $153 |
| 12 | 1831203488 | $131 |
| 13 | 1669462362 | $0 |
| 14 | 1336182021 | $0 |
Showing top 14 of 14 providers billing this code