#3385 of 11K

A6457

HCPCS Procedure Code

HCPCS code A6457 is the #3,385 most-billed Medicaid procedure code, with $1.8M in payments across 131K claims from 2018–2024. The national median cost per claim is $8.95. Costs vary widely — the 90th percentile is $30.88 per claim, 3.5× the median.

Total Paid

$1.8M

0.00% of all spending

Total Claims

131K

Providers

105

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for A6457? Based on 97 providers billing this code nationally.

Median

$8.95

Average

$13.64

Std Dev

$17.63

Max

$119.87

Percentile Distribution (Cost per Claim)

p10

$0.78

p25

$2.34

Median

$8.95

p75

$18.49

p90

$30.88

p95

$39.09

p99

$80.13

50% of providers bill between $2.34 and $18.49 per claim for this code.

90% bill between $0.78 and $30.88.

Top 1% bill above $80.13.

About This Procedure

HCPCS code A6457 was billed by 105 providers across 131K claims, totaling $1.8M in Medicaid payments from 2018–2024. This code was used for 101K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$8.95

Providers Billing

National Spending

$1.8M

Avg/Median Ratio

1.52×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A6457

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1649244138	$335K	$38.87	4.3× median	Top 10%
2	1972841872	$270K	$34.09	3.8× median	Top 10%
3	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$95K	$25.28	2.8× median	Above 75th
4	1306865340	$81K	$23.84	2.7× median	Above 75th
5	1548367063	$63K	$3.83	0.4× median	Below Median
6	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$63K	$18.49	2.1× median	Above 75th
7	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$57K	$14.98	1.7× median	Above Median
8	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$56K	$10.15	1.1× median	Above Median
9	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$49K	$11.98	1.3× median	Above Median
10	1710932173	$48K	$16.68	1.9× median	Above Median
11	1477748119	$48K	$32.75	3.7× median	Top 10%
12	1093229320	$47K	$119.87	13.4× median	Top 1%
13	1255330403	$46K	$7.98	0.9× median	Below Median
14	1770583387	$45K	$40.00	4.5× median	Top 10%
15	1407159817	$40K	$29.63	3.3× median	Above 75th
16	1386688414	$38K	$15.91	1.8× median	Above Median
17	1457602294	$32K	$24.64	2.8× median	Above 75th
18	1346295953	$26K	$10.97	1.2× median	Above Median
19	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$26K	$10.23	1.1× median	Above Median
20	1023143930	$22K	$25.76	2.9× median	Above 75th

Showing top 20 of 105 providers billing this code

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A6449$6.3M A6454$2.8M A6452$2.2M A6456$645K A6450$561K

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