A6259
HCPCS Procedure Code
HCPCS code A6259 is the #5,304 most-billed Medicaid procedure code, with $234K in payments across 4K claims from 2018–2024. The national median cost per claim is $72.74. Costs vary widely — the 90th percentile is $151.43 per claim, 2.1× the median.
Total Paid
$234K
0.00% of all spending
Total Claims
4K
Providers
13
Avg Cost/Claim
$60
National Cost Distribution
How much do providers bill per claim for A6259? Based on 13 providers billing this code nationally.
Median
$72.74
Average
$85.57
Std Dev
$46.26
Max
$168.66
Percentile Distribution (Cost per Claim)
50% of providers bill between $47.65 and $119.59 per claim for this code.
90% bill between $44.28 and $151.43.
Top 1% bill above $167.43.
About This Procedure
HCPCS code A6259 was billed by 13 providers across 4K claims, totaling $234K in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$72.74
Providers Billing
13
National Spending
$234K
Avg/Median Ratio
1.18×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for A6259
| # | Provider | Total Paid |
|---|---|---|
| 1 | Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier | $60K |
| 2 | 1801866173 | $39K |
| 3 | Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies | $29K |
| 4 | 1013124213 | $22K |
| 5 | 1780868877 | $22K |
| 6 | 1225022791 | $19K |
| 7 | 1710932173 | $15K |
| 8 | Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies | $8K |
| 9 | 1457884678 | $8K |
| 10 | 1932566858 | $4K |
| 11 | Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies | $3K |
| 12 | 1750736500 | $2K |
| 13 | Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies | $1K |
Showing top 13 of 13 providers billing this code