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#2523 of 11K

A4250

HCPCS Procedure Code

HCPCS code A4250 is the #2,523 most-billed Medicaid procedure code, with $5.2M in payments across 223K claims from 2018–2024. The national median cost per claim is $4.46. Costs vary widely — the 90th percentile is $24.63 per claim, 5.5× the median.

Total Paid

$5.2M

0.00% of all spending

Total Claims

223K

Providers

92

Avg Cost/Claim

$23

National Cost Distribution

How much do providers bill per claim for A4250? Based on 79 providers billing this code nationally.

Median

$4.46

Average

$9.06

Std Dev

$13.71

Max

$91.42

Percentile Distribution (Cost per Claim)

p10
$0.02
p25
$0.05
Median
$4.46
p75
$12.20
p90
$24.63
p95
$29.56
p99
$58.85

50% of providers bill between $0.05 and $12.20 per claim for this code.

90% bill between $0.02 and $24.63.

Top 1% bill above $58.85.

About This Procedure

HCPCS code A4250 was billed by 92 providers across 223K claims, totaling $5.2M in Medicaid payments from 2018–2024. This code was used for 200K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$4.46

Providers Billing

79

National Spending

$5.2M

Avg/Median Ratio

2.03×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A4250

#ProviderTotal Paid
11912145541$3.4M
21003813064$446K
31487605093$170K
41619956901$145K
5Pal-med Llc

Columbia, SC · Durable Medical Equipment & Medical Supplies

$131K
61972660322$125K
71144244450$123K
81366653545$117K
91033142948$98K
101962440891$50K
11Edwards Health Care Services Inc.

Morehead City, NC · Durable Medical Equipment & Medical Supplies

$42K
121114167111$40K
13Rgh Enterprises, Llc

Twinsburg, OH · Prosthetic/Orthotic Supplier

$27K
141558635235$22K
151265453229$18K
161104800440$18K
171144498817$17K
181770044208$14K
19J&b Medical Supply Co Inc

Wixom, MI · Durable Medical Equipment & Medical Supplies

$12K
201770512501$11K

Showing top 20 of 92 providers billing this code