#5917 of 11K

A4615

HCPCS Procedure Code

HCPCS code A4615 is the #5,917 most-billed Medicaid procedure code, with $119K in payments across 81K claims from 2018–2024. The national median cost per claim is $0.45. Costs vary widely — the 90th percentile is $4.27 per claim, 9.5× the median.

Total Paid

$119K

0.00% of all spending

Total Claims

81K

Providers

130

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for A4615? Based on 102 providers billing this code nationally.

Median

$0.45

Average

$1.81

Std Dev

$5.87

Max

$55.86

Percentile Distribution (Cost per Claim)

p10

$0.03

p25

$0.12

Median

$0.45

p75

$1.01

p90

$4.27

p95

$6.91

p99

$14.48

50% of providers bill between $0.12 and $1.01 per claim for this code.

90% bill between $0.03 and $4.27.

Top 1% bill above $14.48.

About This Procedure

HCPCS code A4615 was billed by 130 providers across 81K claims, totaling $119K in Medicaid payments from 2018–2024. This code was used for 65K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.45

Providers Billing

102

National Spending

$119K

Avg/Median Ratio

4.02×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A4615

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1992850689	$35K	$14.54	32.3× median	Top 1%
2	1467879718	$14K	$4.29	9.5× median	Top 10%
3	Total Longterm Care Inc. Aurora, CO · PACE Provider Organization	$14K	$5.16	11.5× median	Top 10%
4	Bronxcare Health System Bronx, NY · General Acute Care Hospital	$9K	$55.86	124.1× median	Top 1%
5	1639770183	$8K	$5.36	11.9× median	Top 10%
6	1861480048	$6K	$2.29	5.1× median	Above 75th
7	1356925960	$3K	$1.02	2.3× median	Above 75th
8	1033289889	$2K	$2.39	5.3× median	Above 75th
9	1508207804	$2K	$0.38	0.9× median	Below Median
10	1982799375	$2K	$0.33	0.7× median	Below Median
11	1114547114	$1K	$3.20	7.1× median	Above 75th
12	1760513923	$1K	$0.57	1.3× median	Above Median
13	1306961792	$1K	$0.77	1.7× median	Above Median
14	Riverside University Health Systems - Medical Center Moreno Valley, CA · General Acute Care Hospital	$1K	$0.69	1.5× median	Above Median
15	1497933501	$1K	$6.69	14.9× median	Top 10%
16	1780625533	$1K	$1.68	3.7× median	Above 75th
17	1144745951	$1K	$0.89	2.0× median	Above Median
18	1811990302	$926	$0.89	2.0× median	Above Median
19	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$798	$4.48	10.0× median	Top 10%
20	Cambridge Public Health Commission Cambridge, MA · General Acute Care Hospital	$771	$1.07	2.4× median	Above 75th

Showing top 20 of 130 providers billing this code

Related Procedures

A4624$98.4M A4606$66.4M A4605$49.0M A4623$20.0M A4618$1.3M

← All procedures Top providers →