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#1363 of 11K

A4556

HCPCS Procedure Code

HCPCS code A4556 is the #1,363 most-billed Medicaid procedure code, with $25.6M in payments across 521K claims from 2018–2024. The national median cost per claim is $1.69. Costs vary widely — the 90th percentile is $29.89 per claim, 17.7× the median.

Total Paid

$25.6M

0.00% of all spending

Total Claims

521K

Providers

282

Avg Cost/Claim

$49

National Cost Distribution

How much do providers bill per claim for A4556? Based on 203 providers billing this code nationally.

Median

$1.69

Average

$18.00

Std Dev

$96.06

Max

$1,329.44

Percentile Distribution (Cost per Claim)

p10
$0.08
p25
$0.19
Median
$1.69
p75
$9.85
p90
$29.89
p95
$67.88
p99
$150.66

50% of providers bill between $0.19 and $9.85 per claim for this code.

90% bill between $0.08 and $29.89.

Top 1% bill above $150.66.

About This Procedure

HCPCS code A4556 was billed by 282 providers across 521K claims, totaling $25.6M in Medicaid payments from 2018–2024. This code was used for 411K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1.69

Providers Billing

203

National Spending

$25.6M

Avg/Median Ratio

10.65×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A4556

#ProviderTotal Paid
11770511552$22.2M
21932537941$1.2M
31336128149$316K
41205976073$260K
51538668843$248K
61841376076$180K
71629167028$172K
81811990302$82K
91780667824$81K
101972553162$70K
111962431049$65K
121760513923$55K
13Integra Partners Llc

Troy, MI · Orthotic Fitter

$52K
14Home Medical Equipment Specialists Llc

Albuquerque, NM · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies

$46K
151194093229$32K
161588028005$31K
171164923298$27K
181285025973$26K
191043240682$25K
201659765204$24K

Showing top 20 of 282 providers billing this code