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#7044 of 11K

A9540

HCPCS Procedure Code

HCPCS code A9540 is the #7,044 most-billed Medicaid procedure code, with $30K in payments across 5K claims from 2018–2024. The national median cost per claim is $10.89. Costs vary widely — the 90th percentile is $54.67 per claim, 5.0× the median.

Total Paid

$30K

0.00% of all spending

Total Claims

5K

Providers

44

Avg Cost/Claim

$7

National Cost Distribution

How much do providers bill per claim for A9540? Based on 23 providers billing this code nationally.

Median

$10.89

Average

$18.60

Std Dev

$23.43

Max

$86.25

Percentile Distribution (Cost per Claim)

p10
$1.49
p25
$2.75
Median
$10.89
p75
$25.63
p90
$54.67
p95
$68.95
p99
$82.63

50% of providers bill between $2.75 and $25.63 per claim for this code.

90% bill between $1.49 and $54.67.

Top 1% bill above $82.63.

About This Procedure

HCPCS code A9540 was billed by 44 providers across 5K claims, totaling $30K in Medicaid payments from 2018–2024. This code was used for 4K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$10.89

Providers Billing

23

National Spending

$30K

Avg/Median Ratio

1.71×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for A9540

#ProviderTotal Paid
11134194038$8K
2Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$7K
31144274317$4K
4Kennedy University Hospital Inc.

Stratford, NJ · General Acute Care Hospital

$2K
5Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$2K
61427055821$2K
7Atlanticare Regional Medical Center

Pomona, NJ · General Acute Care Hospital

$2K
81437119310$907
9Adventist Health System-sunbelt, Inc

Orlando, FL · Ambulance, Land Transport

$571
101710109186$445
111235134024$305
121780681189$291
13The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$284
141821099474$258
15Temple University Hospital Inc

Philadelphia, PA · General Acute Care Hospital

$227
16Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$181
171366097032$158
181134102080$75
19Virtua - West Jersey Health System Inc.

Voorhees, NJ · General Acute Care Hospital

$54
20Inspira Medical Centers Inc.

Vineland, NJ · General Acute Care Hospital

$42

Showing top 20 of 44 providers billing this code