#5225 of 11K

A6453

HCPCS Procedure Code

HCPCS code A6453 is the #5,225 most-billed Medicaid procedure code, with $257K in payments across 64K claims from 2018–2024. The national median cost per claim is $2.10. Costs vary widely — the 90th percentile is $17.47 per claim, 8.3× the median.

Total Paid

$257K

0.00% of all spending

Total Claims

64K

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for A6453? Based on 61 providers billing this code nationally.

Median

$2.10

Average

$6.18

Std Dev

$9.67

Max

$48.91

Percentile Distribution (Cost per Claim)

p10

$0.38

p25

$0.85

Median

$2.10

p75

$6.81

p90

$17.47

p95

$25.25

p99

$40.07

50% of providers bill between $0.85 and $6.81 per claim for this code.

90% bill between $0.38 and $17.47.

Top 1% bill above $40.07.

About This Procedure

HCPCS code A6453 was billed by 65 providers across 64K claims, totaling $257K in Medicaid payments from 2018–2024. This code was used for 56K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$2.10

Providers Billing

National Spending

$257K

Avg/Median Ratio

2.94×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A6453

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1477748119	$39K	$9.37	4.5× median	Above 75th
2	1164530630	$32K	$15.53	7.4× median	Above 75th
3	1316364011	$20K	$5.84	2.8× median	Above Median
4	1073692794	$19K	$3.17	1.5× median	Above Median
5	1891094108	$15K	$2.43	1.2× median	Above Median
6	1275733206	$15K	$17.47	8.3× median	Above 75th
7	1548367063	$13K	$15.64	7.4× median	Above 75th
8	1538668843	$13K	$2.46	1.2× median	Above Median
9	Medcare Equipment Company, Llc Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$12K	$2.23	1.1× median	Above Median
10	1861480048	$10K	$2.10	1.0× median	Below Median
11	1295805232	$9K	$2.35	1.1× median	Above Median
12	1275944514	$7K	$15.36	7.3× median	Above 75th
13	1578868774	$6K	$20.18	9.6× median	Top 10%
14	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$6K	$18.94	9.0× median	Top 10%
15	1184768293	$5K	$1.09	0.5× median	Below Median
16	1366747800	$4K	$3.91	1.9× median	Above Median
17	1891732889	$4K	$32.54	15.5× median	Top 10%
18	1497831507	$3K	$2.54	1.2× median	Above Median
19	1013124213	$2K	$6.81	3.2× median	Above Median
20	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$2K	$34.18	16.3× median	Top 10%

Showing top 20 of 65 providers billing this code

Related Procedures

A6446$18.9M A6449$6.3M A6454$2.8M A6452$2.2M A6457$1.8M

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