#5208 of 11K

A4331

HCPCS Procedure Code

HCPCS code A4331 is the #5,208 most-billed Medicaid procedure code, with $262K in payments across 69K claims from 2018–2024. The national median cost per claim is $3.49. Costs vary widely — the 90th percentile is $11.18 per claim, 3.2× the median.

Total Paid

$262K

0.00% of all spending

Total Claims

69K

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for A4331? Based on 53 providers billing this code nationally.

Median

$3.49

Average

$4.71

Std Dev

$4.47

Max

$19.17

Percentile Distribution (Cost per Claim)

p10

$1.44

p25

$2.40

Median

$3.49

p75

$4.40

p90

$11.18

p95

$16.10

p99

$18.79

50% of providers bill between $2.40 and $4.40 per claim for this code.

90% bill between $1.44 and $11.18.

Top 1% bill above $18.79.

About This Procedure

HCPCS code A4331 was billed by 53 providers across 69K claims, totaling $262K in Medicaid payments from 2018–2024. This code was used for 60K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3.49

Providers Billing

National Spending

$262K

Avg/Median Ratio

1.35×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A4331

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	J&b Medical Supply Co Inc Wixom, MI · Durable Medical Equipment & Medical Supplies	$45K	$3.33	1.0× median	Below Median
2	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$20K	$3.60	1.0× median	Above Median
3	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$17K	$6.62	1.9× median	Above 75th
4	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$17K	$5.67	1.6× median	Above 75th
5	1801899414	$16K	$5.97	1.7× median	Above 75th
6	1710932173	$15K	$6.38	1.8× median	Above 75th
7	Aeroflow Inc Arden, NC · Durable Medical Equipment & Medical Supplies	$15K	$2.65	0.8× median	Below Median
8	180 Medical Inc Oklahoma City, OK · Durable Medical Equipment & Medical Supplies, Customized Equipment	$10K	$3.72	1.1× median	Above Median
9	Byram Healthcare Centers, Inc. Portland, OR · Durable Medical Equipment & Medical Supplies	$10K	$3.74	1.1× median	Above Median
10	J & B Medical Supply Co Inc Wixom, MI · Durable Medical Equipment & Medical Supplies	$9K	$4.08	1.2× median	Above Median
11	1588704027	$9K	$3.98	1.1× median	Above Median
12	1932324621	$9K	$4.09	1.2× median	Above Median
13	1245265420	$7K	$2.96	0.8× median	Below Median
14	1235288648	$7K	$19.17	5.5× median	Top 1%
15	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$6K	$2.09	0.6× median	Below Median
16	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$6K	$2.40	0.7× median	Below Median
17	1821158692	$5K	$2.97	0.9× median	Below Median
18	1235447442	$5K	$2.50	0.7× median	Below Median
19	1114978731	$4K	$12.32	3.5× median	Top 10%
20	1609024397	$4K	$3.01	0.9× median	Below Median

Showing top 20 of 53 providers billing this code

Related Procedures

A4335Incontinence supply, miscellaneous$100.4M A4322$20.3M A4340$5.9M A4332$3.8M A4338$3.0M

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