#2383 of 11K

A6266

HCPCS Procedure Code

HCPCS code A6266 is the #2,383 most-billed Medicaid procedure code, with $6.2M in payments across 116K claims from 2018–2024. The national median cost per claim is $47.46. Costs vary widely — the 90th percentile is $113.25 per claim, 2.4× the median.

Total Paid

$6.2M

0.00% of all spending

Total Claims

116K

Providers

105

Avg Cost/Claim

$54

National Cost Distribution

How much do providers bill per claim for A6266? Based on 102 providers billing this code nationally.

Median

$47.46

Average

$56.90

Std Dev

$52.51

Max

$237.04

Percentile Distribution (Cost per Claim)

p10

$3.44

p25

$15.70

Median

$47.46

p75

$76.50

p90

$113.25

p95

$168.75

p99

$234.31

50% of providers bill between $15.70 and $76.50 per claim for this code.

90% bill between $3.44 and $113.25.

Top 1% bill above $234.31.

About This Procedure

HCPCS code A6266 was billed by 105 providers across 116K claims, totaling $6.2M in Medicaid payments from 2018–2024. This code was used for 97K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$47.46

Providers Billing

102

National Spending

$6.2M

Avg/Median Ratio

1.20×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A6266

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$799K	$80.42	1.7× median	Above 75th
2	1548367063	$688K	$51.50	1.1× median	Above Median
3	1164553863	$436K	$234.59	4.9× median	Top 1%
4	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$301K	$37.39	0.8× median	Below Median
5	1295800068	$290K	$84.60	1.8× median	Above 75th
6	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$250K	$89.36	1.9× median	Above 75th
7	1275944514	$231K	$66.09	1.4× median	Above Median
8	1649244138	$226K	$51.88	1.1× median	Above Median
9	1376916379	$217K	$98.31	2.1× median	Above 75th
10	Degc Enterprises (U.s.), Inc. Clearwater, FL · Durable Medical Equipment & Medical Supplies	$214K	$156.73	3.3× median	Top 10%
11	1679653356	$186K	$98.73	2.1× median	Above 75th
12	1710057500	$174K	$237.04	5.0× median	Top 1%
13	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$165K	$65.58	1.4× median	Above Median
14	1023054871	$163K	$93.36	2.0× median	Above 75th
15	1396849543	$157K	$68.70	1.4× median	Above Median
16	1346332863	$156K	$139.87	2.9× median	Top 10%
17	1710932173	$126K	$54.00	1.1× median	Above Median
18	1689633083	$120K	$168.90	3.6× median	Top 10%
19	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$79K	$71.68	1.5× median	Above Median
20	1730174764	$78K	$63.36	1.3× median	Above Median

Showing top 20 of 105 providers billing this code

Related Procedures

A6258$9.0M A6257$8.9M A6260$5.7M A6261$280K A6259$234K

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