A6404
HCPCS Procedure Code
HCPCS code A6404 is the #4,618 most-billed Medicaid procedure code, with $486K in payments across 5K claims from 2018–2024. The national median cost per claim is $12.24. Costs vary widely — the 90th percentile is $90.37 per claim, 7.4× the median.
Total Paid
$486K
0.00% of all spending
Total Claims
5K
Providers
7
Avg Cost/Claim
$89
National Cost Distribution
How much do providers bill per claim for A6404? Based on 7 providers billing this code nationally.
Median
$12.24
Average
$36.80
Std Dev
$45.30
Max
$118.64
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.83 and $60.43 per claim for this code.
90% bill between $1.19 and $90.37.
Top 1% bill above $115.81.
About This Procedure
HCPCS code A6404 was billed by 7 providers across 5K claims, totaling $486K in Medicaid payments from 2018–2024. This code was used for 5K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$12.24
Providers Billing
7
National Spending
$486K
Avg/Median Ratio
3.01×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for A6404
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1174745335 | $431K |
| 2 | 1093229320 | $42K |
| 3 | 1417904574 | $11K |
| 4 | 1912397936 | $2K |
| 5 | 1891912432 | $520 |
| 6 | 1124333497 | $327 |
| 7 | 1477545333 | $2 |
Showing top 7 of 7 providers billing this code