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#6593 of 11K

A4263

HCPCS Procedure Code

HCPCS code A4263 is the #6,593 most-billed Medicaid procedure code, with $53K in payments across 3K claims from 2018–2024. The national median cost per claim is $4.01. Costs vary widely — the 90th percentile is $37.53 per claim, 9.4× the median.

Total Paid

$53K

0.00% of all spending

Total Claims

3K

Providers

19

Avg Cost/Claim

$16

National Cost Distribution

How much do providers bill per claim for A4263? Based on 10 providers billing this code nationally.

Median

$4.01

Average

$15.30

Std Dev

$21.86

Max

$65.30

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.06
Median
$4.01
p75
$26.71
p90
$37.53
p95
$51.41
p99
$62.52

50% of providers bill between $0.06 and $26.71 per claim for this code.

90% bill between $0.00 and $37.53.

Top 1% bill above $62.52.

About This Procedure

HCPCS code A4263 was billed by 19 providers across 3K claims, totaling $53K in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$4.01

Providers Billing

10

National Spending

$53K

Avg/Median Ratio

3.82×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A4263

#ProviderTotal Paid
11932517869$35K
21245427756$9K
31669540688$5K
41013468578$4K
51801843685$345
61639101751$69
71255314191$17
81982268298$17
91255682811$3
101346663051$0
111396164216$0
121063513794$0
131588645097$0
141487979647$0
151790893451$0
161851410948$0
171942341466$0
181063561439$0
191346342466$0

Showing top 19 of 19 providers billing this code