#4934 of 11K

A5112

HCPCS Procedure Code

HCPCS code A5112 is the #4,934 most-billed Medicaid procedure code, with $348K in payments across 10K claims from 2018–2024. The national median cost per claim is $27.40.

Total Paid

$348K

0.00% of all spending

Total Claims

10K

Providers

Avg Cost/Claim

$35

National Cost Distribution

How much do providers bill per claim for A5112? Based on 16 providers billing this code nationally.

Median

$27.40

Average

$29.52

Std Dev

$22.08

Max

$89.91

Percentile Distribution (Cost per Claim)

p10

$10.24

p25

$12.04

Median

$27.40

p75

$35.47

p90

$52.16

p95

$69.37

p99

$85.80

50% of providers bill between $12.04 and $35.47 per claim for this code.

90% bill between $10.24 and $52.16.

Top 1% bill above $85.80.

About This Procedure

HCPCS code A5112 was billed by 16 providers across 10K claims, totaling $348K in Medicaid payments from 2018–2024. This code was used for 9K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$27.40

Providers Billing

National Spending

$348K

Avg/Median Ratio

1.08×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A5112

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1801899414	$174K	$33.68	1.2× median	Above Median
2	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$84K	$38.10	1.4× median	Above 75th
3	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$64K	$34.21	1.2× median	Above Median
4	Tenderheart Health Outcomes, Inc. Austin, TX · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition	$6K	$31.40	1.1× median	Above Median
5	1205834322	$5K	$62.52	2.3× median	Top 10%
6	1821083965	$5K	$41.80	1.5× median	Above 75th
7	1356530521	$5K	$89.91	3.3× median	Top 1%
8	Byram Healthcare Centers, Inc. Portland, OR · Durable Medical Equipment & Medical Supplies	$2K	$17.15	0.6× median	Below Median
9	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$2K	$12.05	0.4× median	Below Median
10	1417211533	$747	$12.66	0.5× median	Below Median
11	1144311531	$679	$23.41	0.9× median	Below Median
12	1447270921	$415	$34.59	1.3× median	Above Median
13	1003156274	$167	$11.94	0.4× median	Below Median
14	Degc Enterprises (U.s.), Inc. Clearwater, FL · Durable Medical Equipment & Medical Supplies	$156	$12.02	0.4× median	Below Median
15	1477636272	$120	$8.54	0.3× median	Below Median
16	1346295953	$117	$8.38	0.3× median	Below Median

Showing top 16 of 16 providers billing this code

Related Procedures

A5120$35.7M A5121$4.9M A5122$770K A5114$36K A5102$16K

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