A6243
HCPCS Procedure Code
HCPCS code A6243 is the #5,214 most-billed Medicaid procedure code, with $260K in payments across 2,665 claims from 2018–2024. The national median cost per claim is $125.82.
Total Paid
$260K
0.00% of all spending
Total Claims
2,665
Providers
8
Avg Cost/Claim
$98
National Cost Distribution
How much do providers bill per claim for A6243? Based on 8 providers billing this code nationally.
Median
$125.82
Average
$121.96
Std Dev
$85.10
Max
$222.78
Percentile Distribution (Cost per Claim)
50% of providers bill between $51.64 and $199.68 per claim for this code.
90% bill between $18.14 and $214.07.
Top 1% bill above $221.91.
About This Procedure
HCPCS code A6243 was billed by 8 providers across 2,665 claims, totaling $260K in Medicaid payments from 2018–2024. This code was used for 2,419 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$125.82
Providers Billing
8
National Spending
$260K
Avg/Median Ratio
0.97×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for A6243
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1548367063 | $131K |
| 2 | Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies | $65K |
| 3 | 1013124213 | $28K |
| 4 | Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies | $26K |
| 5 | 1518478478 | $4K |
| 6 | Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies | $3K |
| 7 | 1942251848 | $2K |
| 8 | 1063771798 | $146 |
Showing top 8 of 8 providers billing this code