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#6913 of 11K

A0396

HCPCS Procedure Code

HCPCS code A0396 is the #6,913 most-billed Medicaid procedure code, with $37K in payments across 19K claims from 2018–2024. The national median cost per claim is $0.95. Costs vary widely — the 90th percentile is $9.63 per claim, 10.1× the median.

Total Paid

$37K

0.00% of all spending

Total Claims

19K

Providers

10

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for A0396? Based on 5 providers billing this code nationally.

Median

$0.95

Average

$3.48

Std Dev

$6.64

Max

$15.32

Percentile Distribution (Cost per Claim)

p10
$0.02
p25
$0.04
Median
$0.95
p75
$1.09
p90
$9.63
p95
$12.47
p99
$14.75

50% of providers bill between $0.04 and $1.09 per claim for this code.

90% bill between $0.02 and $9.63.

Top 1% bill above $14.75.

About This Procedure

HCPCS code A0396 was billed by 10 providers across 19K claims, totaling $37K in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.95

Providers Billing

5

National Spending

$37K

Avg/Median Ratio

3.66×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A0396

#ProviderTotal Paid
11487783361$32K
21104922848$3K
31750498440$1K
41619071941$419
51235248089$8
61982733218$0
71982671202$0
81952588329$0
91922391226$0
101366492910$0

Showing top 10 of 10 providers billing this code