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#4740 of 11K

A6455

HCPCS Procedure Code

HCPCS code A6455 is the #4,740 most-billed Medicaid procedure code, with $424K in payments across 6,971 claims from 2018–2024. The national median cost per claim is $2.55. Costs vary widely — the 90th percentile is $55.12 per claim, 21.6× the median.

Total Paid

$424K

0.00% of all spending

Total Claims

6,971

Providers

19

Avg Cost/Claim

$61

National Cost Distribution

How much do providers bill per claim for A6455? Based on 13 providers billing this code nationally.

Median

$2.55

Average

$29.95

Std Dev

$51.17

Max

$185.77

Percentile Distribution (Cost per Claim)

p10
$0.03
p25
$0.44
Median
$2.55
p75
$39.36
p90
$55.12
p95
$108.57
p99
$170.33

50% of providers bill between $0.44 and $39.36 per claim for this code.

90% bill between $0.03 and $55.12.

Top 1% bill above $170.33.

About This Procedure

HCPCS code A6455 was billed by 19 providers across 6,971 claims, totaling $424K in Medicaid payments from 2018–2024. This code was used for 6,610 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$2.55

Providers Billing

13

National Spending

$424K

Avg/Median Ratio

11.75×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A6455

#ProviderTotal Paid
11639231483$210K
21174745335$207K
3H & H Drug Stores, Inc

Glendale, CA · Durable Medical Equipment & Medical Supplies

$2K
4Medline Industries, Lp

Grayslake, IL · Durable Medical Equipment & Medical Supplies

$2K
51710932173$798
61730397175$438
7Byram Healthcare Centers, Inc.

Downers Grove, IL · Durable Medical Equipment & Medical Supplies

$349
81124333497$166
91437628385$105
101376597427$60
11Maimonides Medical Center

Brooklyn, NY · General Acute Care Hospital

$17
121881929586$10
131083623409$7
141588668842$0
151790706901$0
161831193499$0
171831132133$0
181780039966$0
191083006738$0

Showing top 19 of 19 providers billing this code