#3120 of 11K

A6219

HCPCS Procedure Code

HCPCS code A6219 is the #3,120 most-billed Medicaid procedure code, with $2.4M in payments across 261K claims from 2018–2024. The national median cost per claim is $9.59. Costs vary widely — the 90th percentile is $27.01 per claim, 2.8× the median.

Total Paid

$2.4M

0.00% of all spending

Total Claims

261K

Providers

166

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for A6219? Based on 155 providers billing this code nationally.

Median

$9.59

Average

$15.17

Std Dev

$25.15

Max

$243.16

Percentile Distribution (Cost per Claim)

p10

$1.09

p25

$3.23

Median

$9.59

p75

$17.88

p90

$27.01

p95

$53.42

p99

$109.65

50% of providers bill between $3.23 and $17.88 per claim for this code.

90% bill between $1.09 and $27.01.

Top 1% bill above $109.65.

About This Procedure

HCPCS code A6219 was billed by 166 providers across 261K claims, totaling $2.4M in Medicaid payments from 2018–2024. This code was used for 215K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.59

Providers Billing

155

National Spending

$2.4M

Avg/Median Ratio

1.58×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A6219

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$203K	$31.35	3.3× median	Top 10%
2	1548367063	$200K	$12.82	1.3× median	Above Median
3	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$164K	$16.94	1.8× median	Above Median
4	1649244138	$146K	$11.21	1.2× median	Above Median
5	1437194164	$122K	$14.07	1.5× median	Above Median
6	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$112K	$22.12	2.3× median	Above 75th
7	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$106K	$15.20	1.6× median	Above Median
8	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$103K	$16.64	1.7× median	Above Median
9	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$79K	$13.87	1.4× median	Above Median
10	1184722043	$76K	$30.81	3.2× median	Top 10%
11	1730397175	$62K	$3.34	0.3× median	Below Median
12	1023054871	$47K	$14.53	1.5× median	Above Median
13	1376916379	$42K	$2.51	0.3× median	Below Median
14	1710932173	$42K	$12.38	1.3× median	Above Median
15	1730174764	$39K	$10.94	1.1× median	Above Median
16	1346295953	$39K	$16.94	1.8× median	Above Median
17	1962515783	$38K	$5.24	0.5× median	Below Median
18	1275626822	$38K	$24.52	2.6× median	Above 75th
19	H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies	$36K	$32.73	3.4× median	Top 10%
20	1063848968	$36K	$3.27	0.3× median	Below Median

Showing top 20 of 166 providers billing this code

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A6212$60.0M A6210$34.5M A6209$23.9M A6211$14.6M A6213$13.1M

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