Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#3742 of 11K

A4281

HCPCS Procedure Code

HCPCS code A4281 is the #3,742 most-billed Medicaid procedure code, with $1.2M in payments across 111K claims from 2018–2024. The national median cost per claim is $6.31. Costs vary widely — the 90th percentile is $19.51 per claim, 3.1× the median.

Total Paid

$1.2M

0.00% of all spending

Total Claims

111K

Providers

25

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for A4281? Based on 21 providers billing this code nationally.

Median

$6.31

Average

$10.74

Std Dev

$14.52

Max

$66.98

Percentile Distribution (Cost per Claim)

p10
$0.72
p25
$2.56
Median
$6.31
p75
$11.20
p90
$19.51
p95
$25.29
p99
$58.64

50% of providers bill between $2.56 and $11.20 per claim for this code.

90% bill between $0.72 and $19.51.

Top 1% bill above $58.64.

About This Procedure

HCPCS code A4281 was billed by 25 providers across 111K claims, totaling $1.2M in Medicaid payments from 2018–2024. This code was used for 99K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.31

Providers Billing

21

National Spending

$1.2M

Avg/Median Ratio

1.70×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A4281

#ProviderTotal Paid
11902140734$766K
21033221841$217K
3Aeroflow Inc

Arden, NC · Durable Medical Equipment & Medical Supplies

$156K
41801965231$22K
51699021642$21K
61184960874$20K
71215997853$10K
81457772535$9K
91689665911$6K
101306961511$6K
111497707426$4K
121639375835$2K
131255741765$1K
141568702744$930
151245773043$787
16Preferred Home Health Care & Nursing Services Inc.

Mount Laurel, NJ · Home Health

$484
171043249196$144
181790718385$120
191003462581$56
201275523581$22

Showing top 20 of 25 providers billing this code