#2101 of 11K

A6258

HCPCS Procedure Code

HCPCS code A6258 is the #2,101 most-billed Medicaid procedure code, with $9.0M in payments across 158K claims from 2018–2024. The national median cost per claim is $28.94. Costs vary widely — the 90th percentile is $103.46 per claim, 3.6× the median.

Total Paid

$9.0M

0.00% of all spending

Total Claims

158K

Providers

112

Avg Cost/Claim

$57

National Cost Distribution

How much do providers bill per claim for A6258? Based on 101 providers billing this code nationally.

Median

$28.94

Average

$41.02

Std Dev

$42.99

Max

$217.18

Percentile Distribution (Cost per Claim)

p10

$0.83

p25

$8.49

Median

$28.94

p75

$59.72

p90

$103.46

p95

$120.77

p99

$167.44

50% of providers bill between $8.49 and $59.72 per claim for this code.

90% bill between $0.83 and $103.46.

Top 1% bill above $167.44.

About This Procedure

HCPCS code A6258 was billed by 112 providers across 158K claims, totaling $9.0M in Medicaid payments from 2018–2024. This code was used for 136K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$28.94

Providers Billing

101

National Spending

$9.0M

Avg/Median Ratio

1.42×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A6258

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1285821264	$4.5M	$148.98	5.1× median	Top 10%
2	1376797704	$1.3M	$62.74	2.2× median	Above 75th
3	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$424K	$52.21	1.8× median	Above Median
4	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$263K	$59.72	2.1× median	Above 75th
5	1316903545	$224K	$46.87	1.6× median	Above Median
6	Byram Healthcare Centers, Inc. Portland, OR · Durable Medical Equipment & Medical Supplies	$175K	$98.35	3.4× median	Above 75th
7	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$174K	$67.50	2.3× median	Above 75th
8	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$144K	$56.32	1.9× median	Above Median
9	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$130K	$32.10	1.1× median	Above Median
10	1427139641	$128K	$62.03	2.1× median	Above 75th
11	1003813064	$120K	$61.73	2.1× median	Above 75th
12	1346295953	$103K	$39.49	1.4× median	Above Median
13	1609024397	$94K	$88.59	3.1× median	Above 75th
14	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$91K	$45.40	1.6× median	Above Median
15	1710932173	$91K	$34.18	1.2× median	Above Median
16	1013952613	$82K	$23.43	0.8× median	Below Median
17	H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies	$72K	$44.52	1.5× median	Above Median
18	1043212871	$65K	$13.47	0.5× median	Below Median
19	1013911056	$57K	$79.98	2.8× median	Above 75th
20	1649244138	$57K	$24.22	0.8× median	Below Median

Showing top 20 of 112 providers billing this code

Related Procedures

A6250Skin sealant protectant, moisturizer, each ounce$116.4M A6252$27.8M A6253$21.9M A6257$8.9M A6266$6.2M

← All procedures Top providers →