#2453 of 11K

A6260

HCPCS Procedure Code

HCPCS code A6260 is the #2,453 most-billed Medicaid procedure code, with $5.7M in payments across 248K claims from 2018–2024. The national median cost per claim is $10.03. Costs vary widely — the 90th percentile is $39.70 per claim, 4.0× the median.

Total Paid

$5.7M

0.00% of all spending

Total Claims

248K

Providers

161

Avg Cost/Claim

$23

National Cost Distribution

How much do providers bill per claim for A6260? Based on 134 providers billing this code nationally.

Median

$10.03

Average

$16.09

Std Dev

$19.49

Max

$125.46

Percentile Distribution (Cost per Claim)

p10

$0.94

p25

$4.96

Median

$10.03

p75

$19.70

p90

$39.70

p95

$54.66

p99

$93.03

50% of providers bill between $4.96 and $19.70 per claim for this code.

90% bill between $0.94 and $39.70.

Top 1% bill above $93.03.

About This Procedure

HCPCS code A6260 was billed by 161 providers across 248K claims, totaling $5.7M in Medicaid payments from 2018–2024. This code was used for 216K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$10.03

Providers Billing

134

National Spending

$5.7M

Avg/Median Ratio

1.60×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A6260

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1144207911	$1.3M	$53.17	5.3× median	Top 10%
2	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$1.1M	$37.93	3.8× median	Above 75th
3	1922139104	$573K	$57.34	5.7× median	Top 10%
4	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$309K	$13.65	1.4× median	Above Median
5	1801866173	$282K	$61.15	6.1× median	Top 10%
6	1023054871	$172K	$12.92	1.3× median	Above Median
7	1528222957	$145K	$43.12	4.3× median	Top 10%
8	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$138K	$8.43	0.8× median	Below Median
9	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$137K	$8.46	0.8× median	Below Median
10	1306961792	$125K	$23.40	2.3× median	Above 75th
11	1326274655	$113K	$104.46	10.4× median	Top 1%
12	San Juan Regional Medical Center, Inc. Farmington, NM · Audiologist	$78K	$12.37	1.2× median	Above Median
13	1649244138	$64K	$9.66	1.0× median	Below Median
14	1669570172	$56K	$67.42	6.7× median	Top 10%
15	H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies	$56K	$29.45	2.9× median	Above 75th
16	1346295953	$55K	$18.78	1.9× median	Above Median
17	1033190137	$51K	$21.21	2.1× median	Above 75th
18	Shield Denver Health Care Center Inc Aurora, CO · Durable Medical Equipment & Medical Supplies	$48K	$7.27	0.7× median	Below Median
19	1043390370	$48K	$18.86	1.9× median	Above Median
20	1467879718	$48K	$125.46	12.5× median	Top 1%

Showing top 20 of 161 providers billing this code

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