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#2080 of 11K

A9555

HCPCS Procedure Code

HCPCS code A9555 is the #2,080 most-billed Medicaid procedure code, with $9.3M in payments across 60K claims from 2018–2024. The national median cost per claim is $89.11. Costs vary widely — the 90th percentile is $306.81 per claim, 3.4× the median.

Total Paid

$9.3M

0.00% of all spending

Total Claims

60K

Providers

136

Avg Cost/Claim

$156

National Cost Distribution

How much do providers bill per claim for A9555? Based on 103 providers billing this code nationally.

Median

$89.11

Average

$169.01

Std Dev

$326.09

Max

$2,948.32

Percentile Distribution (Cost per Claim)

p10
$4.03
p25
$20.71
Median
$89.11
p75
$195.80
p90
$306.81
p95
$487.46
p99
$920.39

50% of providers bill between $20.71 and $195.80 per claim for this code.

90% bill between $4.03 and $306.81.

Top 1% bill above $920.39.

About This Procedure

HCPCS code A9555 was billed by 136 providers across 60K claims, totaling $9.3M in Medicaid payments from 2018–2024. This code was used for 54K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$89.11

Providers Billing

103

National Spending

$9.3M

Avg/Median Ratio

1.90×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A9555

#ProviderTotal Paid
11730137480$1.9M
21336147859$973K
3Trustees Of The University Of Pennsylvania

Philadelphia, PA · Community/Behavioral Health

$749K
41609907005$704K
51063851335$599K
61144265547$495K
71770830606$394K
81194723601$318K
91356398713$312K
101538244918$295K
111346433059$249K
121144262593$204K
131750846614$186K
141255382545$166K
15Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$135K
161245218619$116K
17Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$100K
181841898293$94K
191831248236$87K
201063886323$83K

Showing top 20 of 136 providers billing this code