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#3009 of 11K

A6454

HCPCS Procedure Code

HCPCS code A6454 is the #3,009 most-billed Medicaid procedure code, with $2.8M in payments across 127K claims from 2018–2024. The national median cost per claim is $15.74. Costs vary widely — the 90th percentile is $56.08 per claim, 3.6× the median.

Total Paid

$2.8M

0.00% of all spending

Total Claims

127K

Providers

99

Avg Cost/Claim

$22

National Cost Distribution

How much do providers bill per claim for A6454? Based on 86 providers billing this code nationally.

Median

$15.74

Average

$27.03

Std Dev

$50.51

Max

$427.43

Percentile Distribution (Cost per Claim)

p10
$0.18
p25
$4.34
Median
$15.74
p75
$32.78
p90
$56.08
p95
$63.97
p99
$187.54

50% of providers bill between $4.34 and $32.78 per claim for this code.

90% bill between $0.18 and $56.08.

Top 1% bill above $187.54.

About This Procedure

HCPCS code A6454 was billed by 99 providers across 127K claims, totaling $2.8M in Medicaid payments from 2018–2024. This code was used for 105K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$15.74

Providers Billing

86

National Spending

$2.8M

Avg/Median Ratio

1.72×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A6454

#ProviderTotal Paid
1Byram Healthcare Centers, Inc.

Torrance, CA · Durable Medical Equipment & Medical Supplies

$350K
2Shield California Health Care Center Inc

Valencia, CA · Durable Medical Equipment & Medical Supplies

$229K
31548367063$226K
41275647299$168K
5Rgh Enterprises, Llc

Twinsburg, OH · Prosthetic/Orthotic Supplier

$139K
6Byram Healthcare Centers, Inc.

Downers Grove, IL · Durable Medical Equipment & Medical Supplies

$130K
7Home Care Delivered, Inc.

Richmond, VA · Durable Medical Equipment & Medical Supplies

$121K
81609024397$111K
9Medline Industries, Lp

Grayslake, IL · Durable Medical Equipment & Medical Supplies

$101K
101427139641$92K
11Shield Denver Health Care Center Inc

Aurora, CO · Durable Medical Equipment & Medical Supplies

$89K
121013124213$79K
131649244138$73K
141710932173$73K
151679653356$71K
161942251848$68K
17Byram Healthcare Centers, Inc.

Portland, OR · Durable Medical Equipment & Medical Supplies

$67K
181346295953$61K
191275703084$54K
20Continuum, Llc

Philadelphia, PA · Durable Medical Equipment & Medical Supplies

$42K

Showing top 20 of 99 providers billing this code