#5398 of 11K

A6407

HCPCS Procedure Code

HCPCS code A6407 is the #5,398 most-billed Medicaid procedure code, with $209K in payments across 14K claims from 2018–2024. The national median cost per claim is $15.86. Costs vary widely — the 90th percentile is $34.02 per claim, 2.1× the median.

Total Paid

$209K

0.00% of all spending

Total Claims

14K

Providers

Avg Cost/Claim

$15

National Cost Distribution

How much do providers bill per claim for A6407? Based on 24 providers billing this code nationally.

Median

$15.86

Average

$18.68

Std Dev

$11.80

Max

$49.81

Percentile Distribution (Cost per Claim)

p10

$4.75

p25

$11.77

Median

$15.86

p75

$24.18

p90

$34.02

p95

$40.88

p99

$47.92

50% of providers bill between $11.77 and $24.18 per claim for this code.

90% bill between $4.75 and $34.02.

Top 1% bill above $47.92.

About This Procedure

HCPCS code A6407 was billed by 24 providers across 14K claims, totaling $209K in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$15.86

Providers Billing

National Spending

$209K

Avg/Median Ratio

1.18×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A6407

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1548367063	$57K	$20.67	1.3× median	Above Median
2	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$27K	$11.98	0.8× median	Below Median
3	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$21K	$26.05	1.6× median	Above 75th
4	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$15K	$49.81	3.1× median	Top 1%
5	1013124213	$14K	$4.91	0.3× median	Below Median
6	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$14K	$16.10	1.0× median	Above Median
7	1649244138	$13K	$12.15	0.8× median	Below Median
8	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$12K	$18.96	1.2× median	Above Median
9	1730174764	$10K	$10.32	0.7× median	Below Median
10	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$9K	$15.57	1.0× median	Below Median
11	1710932173	$7K	$25.32	1.6× median	Above 75th
12	Shield California Health Care Center Inc Valencia, CA · Durable Medical Equipment & Medical Supplies	$3K	$27.05	1.7× median	Above 75th
13	1962515783	$2K	$21.94	1.4× median	Above Median
14	1427139641	$1K	$15.61	1.0× median	Below Median
15	H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies	$759	$21.08	1.3× median	Above Median
16	1275944514	$665	$41.56	2.6× median	Top 10%
17	1275626822	$481	$37.02	2.3× median	Top 10%
18	Medcare Equipment Company, Llc Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$423	$12.09	0.8× median	Below Median
19	1346295953	$286	$23.80	1.5× median	Above Median
20	1801899414	$190	$13.57	0.9× median	Below Median

Showing top 20 of 24 providers billing this code

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A6402$21.2M A6403$1.2M A6404$486K A6410$52K A6413$47K

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