#3204 of 11K

A6452

HCPCS Procedure Code

HCPCS code A6452 is the #3,204 most-billed Medicaid procedure code, with $2.2M in payments across 25K claims from 2018–2024. The national median cost per claim is $83.58. Costs vary widely — the 90th percentile is $212.85 per claim, 2.5× the median.

Total Paid

$2.2M

0.00% of all spending

Total Claims

25K

Providers

Avg Cost/Claim

$90

National Cost Distribution

How much do providers bill per claim for A6452? Based on 37 providers billing this code nationally.

Median

$83.58

Average

$115.72

Std Dev

$104.78

Max

$499.30

Percentile Distribution (Cost per Claim)

p10

$22.02

p25

$52.48

Median

$83.58

p75

$158.90

p90

$212.85

p95

$302.84

p99

$457.67

50% of providers bill between $52.48 and $158.90 per claim for this code.

90% bill between $22.02 and $212.85.

Top 1% bill above $457.67.

About This Procedure

HCPCS code A6452 was billed by 39 providers across 25K claims, totaling $2.2M in Medicaid payments from 2018–2024. This code was used for 19K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$83.58

Providers Billing

National Spending

$2.2M

Avg/Median Ratio

1.38×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A6452

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1326274655	$286K	$499.30	6.0× median	Top 1%
2	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$217K	$122.21	1.5× median	Above Median
3	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$202K	$80.53	1.0× median	Below Median
4	1548367063	$193K	$75.40	0.9× median	Below Median
5	1649244138	$143K	$44.56	0.5× median	Below Median
6	1275703084	$128K	$282.64	3.4× median	Top 10%
7	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$120K	$188.21	2.3× median	Above 75th
8	1013124213	$102K	$73.75	0.9× median	Below Median
9	1427139641	$96K	$84.98	1.0× median	Above Median
10	1912952375	$89K	$184.11	2.2× median	Above 75th
11	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$85K	$77.10	0.9× median	Below Median
12	1326176165	$69K	$42.05	0.5× median	Below Median
13	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$65K	$80.03	1.0× median	Below Median
14	1730174764	$65K	$101.66	1.2× median	Above Median
15	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$48K	$118.89	1.4× median	Above Median
16	1669428124	$43K	$206.23	2.5× median	Above 75th
17	1356530521	$41K	$195.18	2.3× median	Above 75th
18	1710932173	$39K	$59.58	0.7× median	Below Median
19	1275944514	$39K	$52.48	0.6× median	Below Median
20	1346295953	$38K	$92.95	1.1× median	Above Median

Showing top 20 of 39 providers billing this code

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A6446$18.9M A6449$6.3M A6454$2.8M A6457$1.8M A6443$1.1M

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