#4347 of 11K

A6456

HCPCS Procedure Code

HCPCS code A6456 is the #4,347 most-billed Medicaid procedure code, with $645K in payments across 29K claims from 2018–2024. The national median cost per claim is $19.17. Costs vary widely — the 90th percentile is $123.06 per claim, 6.4× the median.

Total Paid

$645K

0.00% of all spending

Total Claims

29K

Providers

Avg Cost/Claim

$22

National Cost Distribution

How much do providers bill per claim for A6456? Based on 30 providers billing this code nationally.

Median

$19.17

Average

$39.78

Std Dev

$51.84

Max

$194.69

Percentile Distribution (Cost per Claim)

p10

$2.10

p25

$9.71

Median

$19.17

p75

$42.04

p90

$123.06

p95

$164.14

p99

$188.03

50% of providers bill between $9.71 and $42.04 per claim for this code.

90% bill between $2.10 and $123.06.

Top 1% bill above $188.03.

About This Procedure

HCPCS code A6456 was billed by 32 providers across 29K claims, totaling $645K in Medicaid payments from 2018–2024. This code was used for 23K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$19.17

Providers Billing

National Spending

$645K

Avg/Median Ratio

2.08×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A6456

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$102K	$39.60	2.1× median	Above Median
2	1013124213	$67K	$9.49	0.5× median	Below Median
3	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$67K	$31.32	1.6× median	Above Median
4	1649244138	$63K	$14.21	0.7× median	Below Median
5	Home Care Delivered, Inc. Richmond, VA · Durable Medical Equipment & Medical Supplies	$49K	$47.58	2.5× median	Above 75th
6	Continuum, Llc Philadelphia, PA · Durable Medical Equipment & Medical Supplies	$48K	$34.36	1.8× median	Above Median
7	1710932173	$48K	$29.19	1.5× median	Above Median
8	1548367063	$44K	$18.92	1.0× median	Below Median
9	1346295953	$43K	$58.15	3.0× median	Above 75th
10	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$33K	$19.42	1.0× median	Above Median
11	1114037942	$23K	$194.69	10.2× median	Top 1%
12	1326176165	$14K	$10.37	0.5× median	Below Median
13	1730174764	$11K	$25.65	1.3× median	Above Median
14	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$8K	$42.85	2.2× median	Above 75th
15	H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies	$5K	$119.53	6.2× median	Above 75th
16	Med Star Surgical & Breathing Equipment Inc. Bronx, NY · Prosthetic/Orthotic Supplier	$5K	$14.46	0.8× median	Below Median
17	1093229320	$4K	$154.88	8.1× median	Top 10%
18	1730397175	$4K	$7.56	0.4× median	Below Median
19	1609024397	$2K	$171.72	9.0× median	Top 10%
20	1073849667	$1K	$13.21	0.7× median	Below Median

Showing top 20 of 32 providers billing this code

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A6446$18.9M A6449$6.3M A6454$2.8M A6452$2.2M A6457$1.8M

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