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#5790 of 11K

A6231

HCPCS Procedure Code

HCPCS code A6231 is the #5,790 most-billed Medicaid procedure code, with $137K in payments across 13K claims from 2018–2024. The national median cost per claim is $13.38. Costs vary widely — the 90th percentile is $35.42 per claim, 2.6× the median.

Total Paid

$137K

0.00% of all spending

Total Claims

13K

Providers

11

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for A6231? Based on 11 providers billing this code nationally.

Median

$13.38

Average

$24.80

Std Dev

$36.12

Max

$128.50

Percentile Distribution (Cost per Claim)

p10
$2.36
p25
$7.21
Median
$13.38
p75
$25.16
p90
$35.42
p95
$81.96
p99
$119.20

50% of providers bill between $7.21 and $25.16 per claim for this code.

90% bill between $2.36 and $35.42.

Top 1% bill above $119.20.

About This Procedure

HCPCS code A6231 was billed by 11 providers across 13K claims, totaling $137K in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.38

Providers Billing

11

National Spending

$137K

Avg/Median Ratio

1.85×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A6231

#ProviderTotal Paid
11013124213$91K
21730397175$38K
31063771798$2K
4Byram Healthcare Centers, Inc.

Torrance, CA · Durable Medical Equipment & Medical Supplies

$2K
51992162911$1K
61225413743$1K
71710452701$474
81649244138$401
91700288941$309
101336750801$293
111700878840$82

Showing top 11 of 11 providers billing this code