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#1435 of 11K

A7521

HCPCS Procedure Code

HCPCS code A7521 is the #1,435 most-billed Medicaid procedure code, with $23.4M in payments across 193K claims from 2018–2024. The national median cost per claim is $39.24. Costs vary widely — the 90th percentile is $165.92 per claim, 4.2× the median.

Total Paid

$23.4M

0.00% of all spending

Total Claims

193K

Providers

170

Avg Cost/Claim

$121

National Cost Distribution

How much do providers bill per claim for A7521? Based on 165 providers billing this code nationally.

Median

$39.24

Average

$76.39

Std Dev

$108.95

Max

$720.57

Percentile Distribution (Cost per Claim)

p10
$5.59
p25
$19.67
Median
$39.24
p75
$82.75
p90
$165.92
p95
$281.44
p99
$508.72

50% of providers bill between $19.67 and $82.75 per claim for this code.

90% bill between $5.59 and $165.92.

Top 1% bill above $508.72.

About This Procedure

HCPCS code A7521 was billed by 170 providers across 193K claims, totaling $23.4M in Medicaid payments from 2018–2024. This code was used for 153K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$39.24

Providers Billing

165

National Spending

$23.4M

Avg/Median Ratio

1.95×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A7521

#ProviderTotal Paid
11326607011$3.0M
2Pediatric Home Respiratory Services Llc

Roseville, MN · Home Health

$2.4M
3Super Care Inc

City Of Industry, CA · Durable Medical Equipment & Medical Supplies

$1.8M
41538128293$1.8M
51902137409$1.3M
61497810048$1.2M
7Apple Homecare Medical Supply Llc

Richardson, TX · Durable Medical Equipment & Medical Supplies, Customized Equipment

$965K
81093873598$948K
91275612673$784K
101710978390$729K
111235329228$722K
121871738153$637K
131134167646$617K
141578999553$586K
15Los Ninos Hospital Inc

Phoenix, AZ · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies

$411K
161811060544$326K
171033289889$292K
181285639914$245K
191013952613$236K
201477748119$207K

Showing top 20 of 170 providers billing this code