#2325 of 11K

A6222

HCPCS Procedure Code

HCPCS code A6222 is the #2,325 most-billed Medicaid procedure code, with $6.7M in payments across 279K claims from 2018–2024. The national median cost per claim is $23.17. Costs vary widely — the 90th percentile is $57.60 per claim, 2.5× the median.

Total Paid

$6.7M

0.00% of all spending

Total Claims

279K

Providers

191

Avg Cost/Claim

$24

National Cost Distribution

How much do providers bill per claim for A6222? Based on 162 providers billing this code nationally.

Median

$23.17

Average

$28.16

Std Dev

$33.22

Max

$230.00

Percentile Distribution (Cost per Claim)

p10

$0.28

p25

$4.14

Median

$23.17

p75

$38.55

p90

$57.60

p95

$78.02

p99

$168.88

50% of providers bill between $4.14 and $38.55 per claim for this code.

90% bill between $0.28 and $57.60.

Top 1% bill above $168.88.

About This Procedure

HCPCS code A6222 was billed by 191 providers across 279K claims, totaling $6.7M in Medicaid payments from 2018–2024. This code was used for 237K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$23.17

Providers Billing

162

National Spending

$6.7M

Avg/Median Ratio

1.22×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A6222

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1548367063	$856K	$25.96	1.1× median	Above Median
2	1679653356	$619K	$96.93	4.2× median	Top 10%
3	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$397K	$50.37	2.2× median	Above 75th
4	Pediatric Home Respiratory Services Llc Roseville, MN · Home Health	$357K	$46.03	2.0× median	Above 75th
5	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$331K	$45.76	2.0× median	Above 75th
6	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$314K	$29.09	1.3× median	Above Median
7	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$284K	$47.81	2.1× median	Above 75th
8	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$222K	$86.04	3.7× median	Top 10%
9	1013124213	$220K	$5.06	0.2× median	Below Median
10	1730174764	$204K	$43.51	1.9× median	Above 75th
11	1649244138	$177K	$20.46	0.9× median	Below Median
12	H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies	$165K	$61.90	2.7× median	Top 10%
13	1295800068	$161K	$45.22	2.0× median	Above 75th
14	1023054871	$139K	$38.60	1.7× median	Above 75th
15	1164553863	$133K	$74.01	3.2× median	Top 10%
16	1710932173	$115K	$32.06	1.4× median	Above Median
17	1346295953	$115K	$38.38	1.7× median	Above Median
18	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$110K	$29.44	1.3× median	Above Median
19	1962515783	$110K	$13.64	0.6× median	Below Median
20	1427139641	$102K	$36.49	1.6× median	Above Median

Showing top 20 of 191 providers billing this code

Related Procedures

A6212$60.0M A6213$13.1M A6216Gauze, non-impregnated, sterile$7.1M A6223$6.8M A6219$2.4M

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