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#687 of 11K

A4223

HCPCS Procedure Code

HCPCS code A4223 is the #687 most-billed Medicaid procedure code, with $105.7M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $60.92. Costs vary widely — the 90th percentile is $290.37 per claim, 4.8× the median.

Total Paid

$105.7M

0.01% of all spending

Total Claims

1.1M

Providers

242

Avg Cost/Claim

$95

National Cost Distribution

How much do providers bill per claim for A4223? Based on 226 providers billing this code nationally.

Median

$60.92

Average

$119.73

Std Dev

$177.52

Max

$1,250.88

Percentile Distribution (Cost per Claim)

p10
$11.67
p25
$26.60
Median
$60.92
p75
$109.13
p90
$290.37
p95
$472.20
p99
$814.03

50% of providers bill between $26.60 and $109.13 per claim for this code.

90% bill between $11.67 and $290.37.

Top 1% bill above $814.03.

About This Procedure

HCPCS code A4223 was billed by 242 providers across 1.1M claims, totaling $105.7M in Medicaid payments from 2018–2024. This code was used for 298K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$60.92

Providers Billing

226

National Spending

$105.7M

Avg/Median Ratio

1.97×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A4223

#ProviderTotal Paid
11972841872$12.3M
21811085103$7.7M
31043339807$5.5M
41255401477$5.1M
51871889212$5.0M
61821171877$4.1M
71831241033$3.5M
81346270527$2.7M
91396852000$2.2M
101366554701$2.2M
111083748867$2.1M
121881639755$2.1M
131518912344$2.0M
141144560434$1.7M
151902182637$1.7M
161922303692$1.5M
171619316981$1.5M
181750484903$1.4M
191215966205$1.3M
201619970845$1.3M

Showing top 20 of 242 providers billing this code