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#4514 of 11K

A6255

HCPCS Procedure Code

HCPCS code A6255 is the #4,514 most-billed Medicaid procedure code, with $538K in payments across 4,969 claims from 2018–2024. The national median cost per claim is $7.85. Costs vary widely — the 90th percentile is $132.29 per claim, 16.9× the median.

Total Paid

$538K

0.00% of all spending

Total Claims

4,969

Providers

7

Avg Cost/Claim

$108

National Cost Distribution

How much do providers bill per claim for A6255? Based on 5 providers billing this code nationally.

Median

$7.85

Average

$53.67

Std Dev

$69.91

Max

$144.16

Percentile Distribution (Cost per Claim)

p10
$0.85
p25
$1.38
Median
$7.85
p75
$114.48
p90
$132.29
p95
$138.23
p99
$142.97

50% of providers bill between $1.38 and $114.48 per claim for this code.

90% bill between $0.85 and $132.29.

Top 1% bill above $142.97.

About This Procedure

HCPCS code A6255 was billed by 7 providers across 4,969 claims, totaling $538K in Medicaid payments from 2018–2024. This code was used for 4,464 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.85

Providers Billing

5

National Spending

$538K

Avg/Median Ratio

6.84×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A6255

#ProviderTotal Paid
11639231483$521K
21205976438$16K
31205089026$1K
41437588704$37
51720037799$17
61225086028$0
71235212721$0

Showing top 7 of 7 providers billing this code