#2830 of 11K

A9286

HCPCS Procedure Code

HCPCS code A9286 is the #2,830 most-billed Medicaid procedure code, with $3.4M in payments across 207K claims from 2018–2024. The national median cost per claim is $11.41. Costs vary widely — the 90th percentile is $35.95 per claim, 3.2× the median.

Total Paid

$3.4M

0.00% of all spending

Total Claims

207K

Providers

Avg Cost/Claim

$17

National Cost Distribution

How much do providers bill per claim for A9286? Based on 52 providers billing this code nationally.

Median

$11.41

Average

$17.39

Std Dev

$25.62

Max

$171.07

Percentile Distribution (Cost per Claim)

p10

$0.36

p25

$2.48

Median

$11.41

p75

$20.76

p90

$35.95

p95

$41.69

p99

$114.29

50% of providers bill between $2.48 and $20.76 per claim for this code.

90% bill between $0.36 and $35.95.

Top 1% bill above $114.29.

About This Procedure

HCPCS code A9286 was billed by 64 providers across 207K claims, totaling $3.4M in Medicaid payments from 2018–2024. This code was used for 187K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.41

Providers Billing

National Spending

$3.4M

Avg/Median Ratio

1.52×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A9286

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$1.1M	$21.37	1.9× median	Above 75th
2	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$417K	$8.27	0.7× median	Below Median
3	Personal Touch Home Care Of Ky, Inc. Fort Thomas, KY · Home Health	$415K	$33.39	2.9× median	Above 75th
4	1316364011	$205K	$20.56	1.8× median	Above Median
5	1780868224	$163K	$30.03	2.6× median	Above 75th
6	1629072665	$136K	$11.56	1.0× median	Above Median
7	Shield Denver Health Care Center Inc Aurora, CO · Durable Medical Equipment & Medical Supplies	$125K	$12.73	1.1× median	Above Median
8	1548281512	$124K	$36.55	3.2× median	Top 10%
9	1528138252	$81K	$59.75	5.2× median	Top 10%
10	1700878030	$79K	$16.57	1.5× median	Above Median
11	1154523561	$75K	$40.63	3.6× median	Top 10%
12	Option 1 Nutrition Solutions Llc Denver, CO · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition	$68K	$7.91	0.7× median	Below Median
13	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$55K	$11.54	1.0× median	Above Median
14	1376530220	$51K	$20.47	1.8× median	Above Median
15	1316903545	$44K	$20.33	1.8× median	Above Median
16	1912995127	$42K	$171.07	15.0× median	Top 1%
17	1538669163	$38K	$31.27	2.7× median	Above 75th
18	1942329990	$35K	$17.09	1.5× median	Above Median
19	1497703516	$31K	$22.30	2.0× median	Above 75th
20	Ease-e Medical Inc. Canon City, CO · Durable Medical Equipment & Medical Supplies	$28K	$17.93	1.6× median	Above Median

Showing top 20 of 64 providers billing this code

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