#3317 of 11K

A6240

HCPCS Procedure Code

HCPCS code A6240 is the #3,317 most-billed Medicaid procedure code, with $1.9M in payments across 35K claims from 2018–2024. The national median cost per claim is $38.71. Costs vary widely — the 90th percentile is $84.66 per claim, 2.2× the median.

Total Paid

$1.9M

0.00% of all spending

Total Claims

35K

Providers

Avg Cost/Claim

$55

National Cost Distribution

How much do providers bill per claim for A6240? Based on 51 providers billing this code nationally.

Median

$38.71

Average

$48.69

Std Dev

$66.25

Max

$454.66

Percentile Distribution (Cost per Claim)

p10

$5.27

p25

$11.24

Median

$38.71

p75

$58.11

p90

$84.66

p95

$92.16

p99

$307.62

50% of providers bill between $11.24 and $58.11 per claim for this code.

90% bill between $5.27 and $84.66.

Top 1% bill above $307.62.

About This Procedure

HCPCS code A6240 was billed by 55 providers across 35K claims, totaling $1.9M in Medicaid payments from 2018–2024. This code was used for 32K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$38.71

Providers Billing

National Spending

$1.9M

Avg/Median Ratio

1.26×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A6240

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1326274655	$575K	$454.66	11.7× median	Top 1%
2	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$178K	$87.77	2.3× median	Top 10%
3	1639231483	$139K	$84.66	2.2× median	Above 75th
4	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$116K	$53.72	1.4× median	Above Median
5	1427139641	$112K	$49.98	1.3× median	Above Median
6	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$110K	$58.68	1.5× median	Above 75th
7	1710932173	$96K	$49.46	1.3× median	Above Median
8	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$90K	$33.05	0.9× median	Below Median
9	1679653356	$79K	$90.07	2.3× median	Top 10%
10	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$61K	$47.18	1.2× median	Above Median
11	1346295953	$47K	$38.71	1.0× median	Below Median
12	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$46K	$23.71	0.6× median	Below Median
13	Med Star Surgical & Breathing Equipment Inc. Bronx, NY · Prosthetic/Orthotic Supplier	$38K	$37.96	1.0× median	Below Median
14	1649244138	$29K	$18.66	0.5× median	Below Median
15	1801866173	$28K	$72.22	1.9× median	Above 75th
16	1023063641	$22K	$56.74	1.5× median	Above Median
17	1164530630	$21K	$48.09	1.2× median	Above Median
18	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$19K	$33.32	0.9× median	Below Median
19	1548367063	$18K	$11.22	0.3× median	Below Median
20	Medcare Equipment Company, Llc Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$16K	$58.36	1.5× median	Above 75th

Showing top 20 of 55 providers billing this code

Related Procedures

A6250Skin sealant protectant, moisturizer, each ounce$116.4M A6234$4.9M A6244$3.7M A6248$2.0M A6247$1.9M

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