#1230 of 11K

A7000

HCPCS Procedure Code

HCPCS code A7000 is the #1,230 most-billed Medicaid procedure code, with $32.3M in payments across 1.6M claims from 2018–2024. The national median cost per claim is $11.83. Costs vary widely — the 90th percentile is $31.90 per claim, 2.7× the median.

Total Paid

$32.3M

0.00% of all spending

Total Claims

1.6M

Providers

641

Avg Cost/Claim

$20

National Cost Distribution

How much do providers bill per claim for A7000? Based on 634 providers billing this code nationally.

Median

$11.83

Average

$15.60

Std Dev

$13.76

Max

$175.13

Percentile Distribution (Cost per Claim)

p10

$4.55

p25

$7.45

Median

$11.83

p75

$19.53

p90

$31.90

p95

$39.47

p99

$63.70

50% of providers bill between $7.45 and $19.53 per claim for this code.

90% bill between $4.55 and $31.90.

Top 1% bill above $63.70.

About This Procedure

HCPCS code A7000 was billed by 641 providers across 1.6M claims, totaling $32.3M in Medicaid payments from 2018–2024. This code was used for 1.4M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.83

Providers Billing

634

National Spending

$32.3M

Avg/Median Ratio

1.32×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A7000

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Apple Homecare Medical Supply Llc Richardson, TX · Durable Medical Equipment & Medical Supplies, Customized Equipment	$1.5M	$41.75	3.5× median	Top 10%
2	Super Care Inc City Of Industry, CA · Durable Medical Equipment & Medical Supplies	$1.2M	$22.11	1.9× median	Above 75th
3	1053364695	$804K	$14.76	1.2× median	Above Median
4	1649228909	$658K	$68.84	5.8× median	Top 1%
5	1013952613	$588K	$29.74	2.5× median	Above 75th
6	1528037538	$587K	$25.75	2.2× median	Above 75th
7	1477748119	$578K	$34.34	2.9× median	Top 10%
8	1447332572	$543K	$67.65	5.7× median	Top 1%
9	1871738153	$489K	$26.55	2.2× median	Above 75th
10	Medco Respiratory Instruments, Inc. Houston, TX · Durable Medical Equipment & Medical Supplies	$471K	$30.03	2.5× median	Above 75th
11	1902137409	$458K	$12.51	1.1× median	Above Median
12	1124015086	$438K	$35.86	3.0× median	Top 10%
13	1720075906	$433K	$63.39	5.4× median	Top 10%
14	1083615991	$426K	$15.06	1.3× median	Above Median
15	1437146594	$415K	$26.02	2.2× median	Above 75th
16	1861480048	$412K	$16.32	1.4× median	Above Median
17	1407159817	$407K	$38.90	3.3× median	Top 10%
18	1437146578	$405K	$175.13	14.8× median	Top 1%
19	1801884952	$398K	$71.44	6.0× median	Top 1%
20	1487641445	$398K	$26.59	2.2× median	Above 75th

Showing top 20 of 641 providers billing this code

Related Procedures

A7005$36.0M A7002$10.7M A7003Administration set for nebulizer, with small volume$6.6M A7010$921K A7007Large volume nebulizer, disposable, unfilled$795K

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