#1531 of 11K

A4623

HCPCS Procedure Code

HCPCS code A4623 is the #1,531 most-billed Medicaid procedure code, with $20.0M in payments across 339K claims from 2018–2024. The national median cost per claim is $60.83. Costs vary widely — the 90th percentile is $151.93 per claim, 2.5× the median.

Total Paid

$20.0M

0.00% of all spending

Total Claims

339K

Providers

227

Avg Cost/Claim

$59

National Cost Distribution

How much do providers bill per claim for A4623? Based on 220 providers billing this code nationally.

Median

$60.83

Average

$75.16

Std Dev

$64.32

Max

$591.40

Percentile Distribution (Cost per Claim)

p10

$13.45

p25

$36.71

Median

$60.83

p75

$104.16

p90

$151.93

p95

$177.20

p99

$267.98

50% of providers bill between $36.71 and $104.16 per claim for this code.

90% bill between $13.45 and $151.93.

Top 1% bill above $267.98.

About This Procedure

HCPCS code A4623 was billed by 227 providers across 339K claims, totaling $20.0M in Medicaid payments from 2018–2024. This code was used for 232K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$60.83

Providers Billing

220

National Spending

$20.0M

Avg/Median Ratio

1.24×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A4623

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1326607011	$3.6M	$591.40	9.7× median	Top 1%
2	Super Care Inc City Of Industry, CA · Durable Medical Equipment & Medical Supplies	$1.6M	$151.21	2.5× median	Above 75th
3	Apria Healthcare Llc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$841K	$156.12	2.6× median	Top 10%
4	1861480048	$539K	$128.75	2.1× median	Above 75th
5	Medcare Equipment Company, Llc Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$439K	$158.15	2.6× median	Top 10%
6	H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies	$374K	$86.23	1.4× median	Above Median
7	1174573513	$328K	$104.54	1.7× median	Above 75th
8	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$314K	$111.57	1.8× median	Above 75th
9	1255632394	$304K	$183.35	3.0× median	Top 10%
10	1093761611	$285K	$131.04	2.2× median	Above 75th
11	1720244296	$282K	$111.94	1.8× median	Above 75th
12	1013124213	$272K	$18.75	0.3× median	Below Median
13	1083615991	$268K	$77.92	1.3× median	Above Median
14	Palmetto Oxygen Llc Cary, NC · Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies	$250K	$63.01	1.0× median	Above Median
15	1851328157	$247K	$69.68	1.1× median	Above Median
16	1871738153	$245K	$173.93	2.9× median	Top 10%
17	1861592602	$223K	$151.69	2.5× median	Above 75th
18	1649228909	$218K	$81.77	1.3× median	Above Median
19	1285803775	$215K	$113.27	1.9× median	Above 75th
20	1023054871	$207K	$78.27	1.3× median	Above Median

Showing top 20 of 227 providers billing this code

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A4624$98.4M A4629$33.3M A4627$18.6M A4628$11.7M A4630$1.8M

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