#2571 of 11K

A6234

HCPCS Procedure Code

HCPCS code A6234 is the #2,571 most-billed Medicaid procedure code, with $4.9M in payments across 111K claims from 2018–2024. The national median cost per claim is $42.35. Costs vary widely — the 90th percentile is $102.12 per claim, 2.4× the median.

Total Paid

$4.9M

0.00% of all spending

Total Claims

111K

Providers

Avg Cost/Claim

$44

National Cost Distribution

How much do providers bill per claim for A6234? Based on 93 providers billing this code nationally.

Median

$42.35

Average

$48.82

Std Dev

$36.94

Max

$154.09

Percentile Distribution (Cost per Claim)

p10

$8.37

p25

$16.73

Median

$42.35

p75

$67.64

p90

$102.12

p95

$115.24

p99

$146.64

50% of providers bill between $16.73 and $67.64 per claim for this code.

90% bill between $8.37 and $102.12.

Top 1% bill above $146.64.

About This Procedure

HCPCS code A6234 was billed by 97 providers across 111K claims, totaling $4.9M in Medicaid payments from 2018–2024. This code was used for 100K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$42.35

Providers Billing

National Spending

$4.9M

Avg/Median Ratio

1.15×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A6234

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1902137409	$466K	$43.26	1.0× median	Above Median
2	1407159817	$423K	$130.48	3.1× median	Top 10%
3	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$321K	$59.35	1.4× median	Above Median
4	1477748119	$287K	$58.19	1.4× median	Above Median
5	1013952613	$276K	$53.91	1.3× median	Above Median
6	Apple Homecare Medical Supply Llc Richardson, TX · Durable Medical Equipment & Medical Supplies, Customized Equipment	$179K	$48.80	1.2× median	Above Median
7	1306865340	$160K	$89.02	2.1× median	Above 75th
8	1013124213	$154K	$9.38	0.2× median	Below Median
9	1528037538	$152K	$55.80	1.3× median	Above Median
10	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$151K	$51.54	1.2× median	Above Median
11	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$149K	$68.21	1.6× median	Above 75th
12	1124132154	$147K	$46.37	1.1× median	Above Median
13	1861480048	$133K	$99.63	2.4× median	Above 75th
14	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$131K	$38.28	0.9× median	Below Median
15	1194859629	$120K	$53.04	1.3× median	Above Median
16	1730221599	$119K	$99.27	2.3× median	Above 75th
17	1548367063	$106K	$34.87	0.8× median	Below Median
18	Medco Respiratory Instruments, Inc. Houston, TX · Durable Medical Equipment & Medical Supplies	$98K	$59.13	1.4× median	Above Median
19	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$94K	$39.59	0.9× median	Below Median
20	1043212871	$92K	$19.37	0.5× median	Below Median

Showing top 20 of 97 providers billing this code

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A6244$3.7M A6240$1.9M A6236$1.4M A6229$619K A6224$597K

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