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#4262 of 11K

A4268

HCPCS Procedure Code

HCPCS code A4268 is the #4,262 most-billed Medicaid procedure code, with $705K in payments across 61K claims from 2018–2024. The national median cost per claim is $7.39. Costs vary widely — the 90th percentile is $23.21 per claim, 3.1× the median.

Total Paid

$705K

0.00% of all spending

Total Claims

61K

Providers

39

Avg Cost/Claim

$12

National Cost Distribution

How much do providers bill per claim for A4268? Based on 34 providers billing this code nationally.

Median

$7.39

Average

$10.37

Std Dev

$8.89

Max

$36.66

Percentile Distribution (Cost per Claim)

p10
$2.22
p25
$3.85
Median
$7.39
p75
$14.28
p90
$23.21
p95
$26.31
p99
$34.48

50% of providers bill between $3.85 and $14.28 per claim for this code.

90% bill between $2.22 and $23.21.

Top 1% bill above $34.48.

About This Procedure

HCPCS code A4268 was billed by 39 providers across 61K claims, totaling $705K in Medicaid payments from 2018–2024. This code was used for 56K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.39

Providers Billing

34

National Spending

$705K

Avg/Median Ratio

1.40×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A4268

#ProviderTotal Paid
11538152491$262K
21043268568$103K
31356481436$100K
41902855026$68K
51801154463$55K
61275030009$27K
71023253028$22K
81265462865$22K
91871611806$9K
10City & County Of San Francisco

San Francisco, CA · Case Manager/Care Coordinator

$8K
111316044522$5K
121467643130$5K
131053680827$3K
141477708469$2K
151962650820$2K
161487772836$2K
171679572788$1K
181740263326$1K
191881743631$1K
201902028541$960

Showing top 20 of 39 providers billing this code