#377 of 11K

A7030

Full face mask for CPAP device

Full face mask for CPAP device is the #377 most-billed Medicaid procedure code, with $295.2M in payments across 4.9M claims from 2018–2024. The national median cost per claim is $56.36.

Total Paid

$295.2M

0.03% of all spending

Total Claims

4.9M

Providers

Avg Cost/Claim

$61

National Cost Distribution

How much do providers bill per claim for A7030? Based on 3K providers billing this code nationally.

Median

$56.36

Average

$59.58

Std Dev

$29.34

Max

$219.62

Percentile Distribution (Cost per Claim)

p10

$24.95

p25

$38.99

Median

$56.36

p75

$77.89

p90

$97.25

p95

$110.62

p99

$139.62

50% of providers bill between $38.99 and $77.89 per claim for this code.

90% bill between $24.95 and $97.25.

Top 1% bill above $139.62.

About This Procedure

HCPCS code A7030 (Full face mask for CPAP device) was billed by 3K providers across 4.9M claims, totaling $295.2M in Medicaid payments from 2018–2024. This code was used for 4.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$56.36

Providers Billing

National Spending

$295.2M

Avg/Median Ratio

1.06×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A7030

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1396851184	$5.9M	$65.91	1.2× median	Above Median
2	Apria Healthcare Llc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$5.2M	$93.08	1.7× median	Above 75th
3	Medcare Equipment Company, Llc Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$4.3M	$101.14	1.8× median	Top 10%
4	1962426122	$4.0M	$73.29	1.3× median	Above Median
5	Home Medical Equipment Specialists Llc Albuquerque, NM · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$3.4M	$99.15	1.8× median	Top 10%
6	1134122047	$2.6M	$85.63	1.5× median	Above 75th
7	Med Star Surgical & Breathing Equipment Inc. Bronx, NY · Prosthetic/Orthotic Supplier	$2.6M	$58.51	1.0× median	Above Median
8	1568465938	$2.2M	$46.76	0.8× median	Below Median
9	1730182023	$2.0M	$53.90	1.0× median	Below Median
10	1891275590	$1.9M	$39.56	0.7× median	Below Median
11	1134303902	$1.9M	$49.00	0.9× median	Below Median
12	1033142484	$1.8M	$76.85	1.4× median	Above Median
13	1851328157	$1.7M	$71.23	1.3× median	Above Median
14	1659361947	$1.7M	$70.41	1.2× median	Above Median
15	Integra Partners Llc Troy, MI · Orthotic Fitter	$1.7M	$82.62	1.5× median	Above 75th
16	1003154352	$1.6M	$68.17	1.2× median	Above Median
17	1164612040	$1.6M	$131.82	2.3× median	Top 10%
18	Indiana University Health, Inc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$1.5M	$81.07	1.4× median	Above 75th
19	1972554939	$1.5M	$52.03	0.9× median	Below Median
20	1831289826	$1.4M	$116.52	2.1× median	Top 10%

Showing top 20 of 3K providers billing this code

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A7031$155.5M A7034$137.8M A7035$87.7M A7032$74.0M A7038$61.1M

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