#4346 of 11K

A9537

HCPCS Procedure Code

HCPCS code A9537 is the #4,346 most-billed Medicaid procedure code, with $646K in payments across 20K claims from 2018–2024. The national median cost per claim is $33.72. Costs vary widely — the 90th percentile is $101.43 per claim, 3.0× the median.

Total Paid

$646K

0.00% of all spending

Total Claims

20K

Providers

124

Avg Cost/Claim

$33

National Cost Distribution

How much do providers bill per claim for A9537? Based on 79 providers billing this code nationally.

Median

$33.72

Average

$43.10

Std Dev

$35.66

Max

$160.28

Percentile Distribution (Cost per Claim)

p10

$4.95

p25

$16.05

Median

$33.72

p75

$59.15

p90

$101.43

p95

$110.95

p99

$130.97

50% of providers bill between $16.05 and $59.15 per claim for this code.

90% bill between $4.95 and $101.43.

Top 1% bill above $130.97.

About This Procedure

HCPCS code A9537 was billed by 124 providers across 20K claims, totaling $646K in Medicaid payments from 2018–2024. This code was used for 18K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$33.72

Providers Billing

National Spending

$646K

Avg/Median Ratio

1.28×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A9537

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1972004489	$116K	$39.13	1.2× median	Above Median
2	Baptist Healthcare System Inc Corbin, KY · General Acute Care Hospital	$63K	$49.10	1.5× median	Above Median
3	1699704254	$54K	$122.01	3.6× median	Top 10%
4	Ashland Hospital Corporation Ashland, KY · Clinic/Center, Rural Health	$34K	$60.15	1.8× median	Above 75th
5	1720023997	$31K	$42.26	1.3× median	Above Median
6	1629015698	$29K	$120.28	3.6× median	Top 10%
7	Norton Hospitals Inc Louisville, KY · General Acute Care Hospital	$28K	$28.73	0.9× median	Below Median
8	Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital	$28K	$68.54	2.0× median	Above 75th
9	1558313213	$20K	$83.64	2.5× median	Above 75th
10	1639124142	$18K	$122.70	3.6× median	Top 10%
11	Owensboro Health Inc Owensboro, KY · General Acute Care Hospital	$15K	$37.75	1.1× median	Above Median
12	Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital	$15K	$40.63	1.2× median	Above Median
13	1619038247	$13K	$104.80	3.1× median	Top 10%
14	1609869916	$12K	$16.30	0.5× median	Below Median
15	1447231956	$11K	$89.35	2.6× median	Above 75th
16	1568452290	$11K	$90.96	2.7× median	Above 75th
17	1184606600	$9K	$78.86	2.3× median	Above 75th
18	1538157508	$9K	$48.89	1.4× median	Above Median
19	Beverly Radiology Medical Group Iii Los Angeles, CA · Radiology, Diagnostic Radiology	$9K	$28.85	0.9× median	Below Median
20	Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital	$9K	$26.97	0.8× median	Below Median

Showing top 20 of 124 providers billing this code

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