A6257
HCPCS Procedure Code
HCPCS code A6257 is the #2,107 most-billed Medicaid procedure code, with $8.9M in payments across 483K claims from 2018–2024. The national median cost per claim is $10.48. Costs vary widely — the 90th percentile is $35.94 per claim, 3.4× the median.
Total Paid
$8.9M
0.00% of all spending
Total Claims
483K
Providers
174
Avg Cost/Claim
$18
National Cost Distribution
How much do providers bill per claim for A6257? Based on 159 providers billing this code nationally.
Median
$10.48
Average
$17.06
Std Dev
$23.10
Max
$163.72
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.13 and $21.51 per claim for this code.
90% bill between $0.40 and $35.94.
Top 1% bill above $111.51.
About This Procedure
HCPCS code A6257 was billed by 174 providers across 483K claims, totaling $8.9M in Medicaid payments from 2018–2024. This code was used for 423K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$10.48
Providers Billing
159
National Spending
$8.9M
Avg/Median Ratio
1.63×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for A6257
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1477509628 | $989K |
| 2 | 1962731570 | $679K |
| 3 | 1366653545 | $674K |
| 4 | 1770512501 | $591K |
| 5 | Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier | $425K |
| 6 | Edwards Health Care Services, Inc. Hudson, OH · Durable Medical Equipment & Medical Supplies | $409K |
| 7 | Pal-med Llc Columbia, SC · Durable Medical Equipment & Medical Supplies | $402K |
| 8 | 1003813064 | $297K |
| 9 | 1033142948 | $296K |
| 10 | 1982792586 | $261K |
| 11 | 1740318880 | $259K |
| 12 | 1114167111 | $248K |
| 13 | 1164537452 | $241K |
| 14 | 1891094108 | $220K |
| 15 | Minimed Distribution Corp. Northridge, CA · Durable Medical Equipment & Medical Supplies | $214K |
| 16 | Degc Enterprises (U.s.), Inc. Clearwater, FL · Durable Medical Equipment & Medical Supplies | $190K |
| 17 | Edwards Health Care Services Inc. Morehead City, NC · Durable Medical Equipment & Medical Supplies | $180K |
| 18 | 1902137409 | $170K |
| 19 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $160K |
| 20 | 1730159617 | $159K |
Showing top 20 of 174 providers billing this code