#1753 of 11K

A6211

HCPCS Procedure Code

HCPCS code A6211 is the #1,753 most-billed Medicaid procedure code, with $14.6M in payments across 22K claims from 2018–2024. The national median cost per claim is $355.51. Costs vary widely — the 90th percentile is $1,018.90 per claim, 2.9× the median.

Total Paid

$14.6M

0.00% of all spending

Total Claims

22K

Providers

Avg Cost/Claim

$660

National Cost Distribution

How much do providers bill per claim for A6211? Based on 34 providers billing this code nationally.

Median

$355.51

Average

$496.55

Std Dev

$569.37

Max

$2,844.03

Percentile Distribution (Cost per Claim)

p10

$36.08

p25

$110.40

Median

$355.51

p75

$585.42

p90

$1,018.90

p95

$1,429.88

p99

$2,467.95

50% of providers bill between $110.40 and $585.42 per claim for this code.

90% bill between $36.08 and $1,018.90.

Top 1% bill above $2,467.95.

About This Procedure

HCPCS code A6211 was billed by 36 providers across 22K claims, totaling $14.6M in Medicaid payments from 2018–2024. This code was used for 18K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$355.51

Providers Billing

National Spending

$14.6M

Avg/Median Ratio

1.40×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A6211

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1649244138	$9.1M	$1,282.06	3.6× median	Top 10%
2	1780868877	$746K	$857.62	2.4× median	Above 75th
3	1902137409	$631K	$271.52	0.8× median	Below Median
4	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$546K	$237.29	0.7× median	Below Median
5	1326274655	$496K	$796.72	2.2× median	Above 75th
6	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$478K	$522.29	1.5× median	Above Median
7	1710932173	$446K	$501.46	1.4× median	Above Median
8	1548367063	$378K	$247.37	0.7× median	Below Median
9	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$321K	$569.94	1.6× median	Above Median
10	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$310K	$311.92	0.9× median	Below Median
11	1770583387	$290K	$1,704.39	4.8× median	Top 10%
12	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$181K	$590.58	1.7× median	Above 75th
13	1639231483	$133K	$508.83	1.4× median	Above Median
14	1124132154	$120K	$502.81	1.4× median	Above Median
15	1730246950	$114K	$2,844.03	8.0× median	Top 1%
16	1477138386	$74K	$817.60	2.3× median	Above 75th
17	1013124213	$63K	$36.62	0.1× median	Below Median
18	1447374780	$48K	$285.51	0.8× median	Below Median
19	1316364011	$42K	$101.27	0.3× median	Below Median
20	1386962926	$20K	$1,088.02	3.1× median	Top 10%

Showing top 20 of 36 providers billing this code

Related Procedures

A6212$60.0M A6210$34.5M A6209$23.9M A6213$13.1M A6216Gauze, non-impregnated, sterile$7.1M

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