#902 of 11K

A7038

HCPCS Procedure Code

HCPCS code A7038 is the #902 most-billed Medicaid procedure code, with $61.1M in payments across 13.9M claims from 2018–2024. The national median cost per claim is $3.53.

Total Paid

$61.1M

0.01% of all spending

Total Claims

13.9M

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for A7038? Based on 4K providers billing this code nationally.

Median

$3.53

Average

$4.20

Std Dev

$3.46

Max

$52.94

Percentile Distribution (Cost per Claim)

p10

$1.52

p25

$2.31

Median

$3.53

p75

$5.10

p90

$6.87

p95

$9.36

p99

$17.79

50% of providers bill between $2.31 and $5.10 per claim for this code.

90% bill between $1.52 and $6.87.

Top 1% bill above $17.79.

About This Procedure

HCPCS code A7038 was billed by 4K providers across 13.9M claims, totaling $61.1M in Medicaid payments from 2018–2024. This code was used for 12.4M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3.53

Providers Billing

National Spending

$61.1M

Avg/Median Ratio

1.19×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A7038

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Apria Healthcare Llc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$1.3M	$11.32	3.2× median	Top 10%
2	1801129135	$971K	$8.58	2.4× median	Top 10%
3	1922046085	$928K	$36.11	10.2× median	Top 1%
4	1396851184	$594K	$2.91	0.8× median	Below Median
5	Home Medical Equipment Specialists Llc Albuquerque, NM · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$563K	$8.74	2.5× median	Top 10%
6	1255632394	$485K	$27.94	7.9× median	Top 1%
7	1134303902	$482K	$3.46	1.0× median	Below Median
8	Med Star Surgical & Breathing Equipment Inc. Bronx, NY · Prosthetic/Orthotic Supplier	$479K	$3.94	1.1× median	Above Median
9	1639354368	$477K	$29.53	8.4× median	Top 1%
10	Medcare Equipment Company, Llc Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$473K	$5.56	1.6× median	Above 75th
11	1245221092	$440K	$2.96	0.8× median	Below Median
12	1841488988	$409K	$14.99	4.2× median	Top 10%
13	1962426122	$399K	$4.09	1.2× median	Above Median
14	1730182023	$393K	$2.83	0.8× median	Below Median
15	Super Care Inc City Of Industry, CA · Durable Medical Equipment & Medical Supplies	$388K	$7.68	2.2× median	Top 10%
16	1548336423	$386K	$17.74	5.0× median	Top 10%
17	1144767542	$386K	$10.54	3.0× median	Top 10%
18	1659361947	$372K	$4.16	1.2× median	Above Median
19	1891275590	$356K	$2.59	0.7× median	Below Median
20	1073551446	$340K	$5.39	1.5× median	Above 75th

Showing top 20 of 4K providers billing this code

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A7030Full face mask for CPAP device$295.2M A7031$155.5M A7034$137.8M A7035$87.7M A7032$74.0M

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