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#543 of 11K

A7031

HCPCS Procedure Code

HCPCS code A7031 is the #543 most-billed Medicaid procedure code, with $155.5M in payments across 5.5M claims from 2018–2024. The national median cost per claim is $25.17.

Total Paid

$155.5M

0.01% of all spending

Total Claims

5.5M

Providers

3K

Avg Cost/Claim

$28

National Cost Distribution

How much do providers bill per claim for A7031? Based on 3K providers billing this code nationally.

Median

$25.17

Average

$27.04

Std Dev

$14.77

Max

$191.51

Percentile Distribution (Cost per Claim)

p10
$11.52
p25
$18.48
Median
$25.17
p75
$33.62
p90
$42.71
p95
$52.76
p99
$73.74

50% of providers bill between $18.48 and $33.62 per claim for this code.

90% bill between $11.52 and $42.71.

Top 1% bill above $73.74.

About This Procedure

HCPCS code A7031 was billed by 3K providers across 5.5M claims, totaling $155.5M in Medicaid payments from 2018–2024. This code was used for 4.9M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$25.17

Providers Billing

3K

National Spending

$155.5M

Avg/Median Ratio

1.07×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A7031

#ProviderTotal Paid
11396851184$2.4M
2Apria Healthcare Llc

Indianapolis, IN · Durable Medical Equipment & Medical Supplies

$2.1M
3Med Star Surgical & Breathing Equipment Inc.

Bronx, NY · Prosthetic/Orthotic Supplier

$2.0M
4Home Medical Equipment Specialists Llc

Albuquerque, NM · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies

$1.9M
51891275590$1.8M
6Medcare Equipment Company, Llc

Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies

$1.8M
71659361947$1.6M
81962426122$1.5M
91730182023$1.3M
101003154352$1.3M
111134303902$1.3M
121245221092$1.3M
131720387624$1.1M
141134120074$1.1M
151164827531$1.1M
161568465938$952K
171952356735$893K
18Indiana University Health, Inc

Indianapolis, IN · Durable Medical Equipment & Medical Supplies

$888K
191134122047$860K
201831289826$794K

Showing top 20 of 3K providers billing this code