#1657 of 11K

A4225

HCPCS Procedure Code

HCPCS code A4225 is the #1,657 most-billed Medicaid procedure code, with $16.8M in payments across 691K claims from 2018–2024. The national median cost per claim is $22.71.

Total Paid

$16.8M

0.00% of all spending

Total Claims

691K

Providers

Avg Cost/Claim

$24

National Cost Distribution

How much do providers bill per claim for A4225? Based on 75 providers billing this code nationally.

Median

$22.71

Average

$25.86

Std Dev

$32.80

Max

$270.49

Percentile Distribution (Cost per Claim)

p10

$4.95

p25

$12.59

Median

$22.71

p75

$27.91

p90

$38.70

p95

$55.71

p99

$134.89

50% of providers bill between $12.59 and $27.91 per claim for this code.

90% bill between $4.95 and $38.70.

Top 1% bill above $134.89.

About This Procedure

HCPCS code A4225 was billed by 78 providers across 691K claims, totaling $16.8M in Medicaid payments from 2018–2024. This code was used for 608K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$22.71

Providers Billing

National Spending

$16.8M

Avg/Median Ratio

1.14×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A4225

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$4.0M	$26.69	1.2× median	Above Median
2	Minimed Distribution Corp. Northridge, CA · Durable Medical Equipment & Medical Supplies	$3.1M	$26.81	1.2× median	Above Median
3	1316903545	$981K	$49.33	2.2× median	Top 10%
4	Degc Enterprises (U.s.), Inc. Clearwater, FL · Durable Medical Equipment & Medical Supplies	$950K	$12.27	0.5× median	Below Median
5	1477509628	$909K	$29.79	1.3× median	Above 75th
6	1619295516	$795K	$39.10	1.7× median	Top 10%
7	1164537452	$643K	$26.16	1.2× median	Above Median
8	1609024397	$447K	$27.22	1.2× median	Above Median
9	1023438538	$446K	$15.90	0.7× median	Below Median
10	Byram Healthcare Centers, Inc. Portland, OR · Durable Medical Equipment & Medical Supplies	$437K	$24.25	1.1× median	Above Median
11	1093711996	$431K	$27.52	1.2× median	Above Median
12	Pal-med Llc Columbia, SC · Durable Medical Equipment & Medical Supplies	$413K	$32.39	1.4× median	Above 75th
13	1124213855	$329K	$32.27	1.4× median	Above 75th
14	1598094104	$231K	$25.79	1.1× median	Above Median
15	Edwards Health Care Services Inc. Morehead City, NC · Durable Medical Equipment & Medical Supplies	$208K	$19.95	0.9× median	Below Median
16	1710932173	$186K	$23.15	1.0× median	Above Median
17	Edwards Health Care Services, Inc. Hudson, OH · Durable Medical Equipment & Medical Supplies	$184K	$11.55	0.5× median	Below Median
18	1750473252	$178K	$26.25	1.2× median	Above Median
19	1356716534	$163K	$19.22	0.8× median	Below Median
20	1831289826	$157K	$87.25	3.8× median	Top 10%

Showing top 20 of 78 providers billing this code

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A4230Infusion supplies, non-chemotherapy, per visit$332.1M A4223$105.7M A4222$96.4M A4232$83.2M A4224$31.6M

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