#2312 of 11K

A6223

HCPCS Procedure Code

HCPCS code A6223 is the #2,312 most-billed Medicaid procedure code, with $6.8M in payments across 165K claims from 2018–2024. The national median cost per claim is $35.60. Costs vary widely — the 90th percentile is $78.46 per claim, 2.2× the median.

Total Paid

$6.8M

0.00% of all spending

Total Claims

165K

Providers

136

Avg Cost/Claim

$41

National Cost Distribution

How much do providers bill per claim for A6223? Based on 120 providers billing this code nationally.

Median

$35.60

Average

$41.76

Std Dev

$42.32

Max

$351.00

Percentile Distribution (Cost per Claim)

p10

$0.89

p25

$15.00

Median

$35.60

p75

$56.58

p90

$78.46

p95

$108.65

p99

$141.95

50% of providers bill between $15.00 and $56.58 per claim for this code.

90% bill between $0.89 and $78.46.

Top 1% bill above $141.95.

About This Procedure

HCPCS code A6223 was billed by 136 providers across 165K claims, totaling $6.8M in Medicaid payments from 2018–2024. This code was used for 143K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$35.60

Providers Billing

120

National Spending

$6.8M

Avg/Median Ratio

1.17×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A6223

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1649244138	$492K	$51.86	1.5× median	Above Median
2	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$481K	$49.52	1.4× median	Above Median
3	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$474K	$66.92	1.9× median	Above 75th
4	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$451K	$114.18	3.2× median	Top 10%
5	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$448K	$36.31	1.0× median	Above Median
6	1548367063	$376K	$39.79	1.1× median	Above Median
7	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$322K	$65.04	1.8× median	Above 75th
8	1710932173	$236K	$43.84	1.2× median	Above Median
9	1427139641	$224K	$50.40	1.4× median	Above Median
10	1609024397	$222K	$77.86	2.2× median	Above 75th
11	1730174764	$192K	$39.42	1.1× median	Above Median
12	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$190K	$32.64	0.9× median	Below Median
13	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$171K	$42.13	1.2× median	Above Median
14	1093229320	$171K	$141.62	4.0× median	Top 10%
15	1275703084	$147K	$57.27	1.6× median	Above 75th
16	1801899414	$146K	$94.22	2.6× median	Top 10%
17	1275647299	$137K	$116.90	3.3× median	Top 10%
18	H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies	$134K	$47.51	1.3× median	Above Median
19	1639231483	$132K	$57.80	1.6× median	Above 75th
20	1346295953	$128K	$34.88	1.0× median	Below Median

Showing top 20 of 136 providers billing this code

Related Procedures

A6213$13.1M A6216Gauze, non-impregnated, sterile$7.1M A6222$6.7M A6219$2.4M A6220$1.3M

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