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#4196 of 11K

A9541

HCPCS Procedure Code

HCPCS code A9541 is the #4,196 most-billed Medicaid procedure code, with $760K in payments across 29K claims from 2018–2024. The national median cost per claim is $27.26. Costs vary widely — the 90th percentile is $165.84 per claim, 6.1× the median.

Total Paid

$760K

0.00% of all spending

Total Claims

29K

Providers

168

Avg Cost/Claim

$27

National Cost Distribution

How much do providers bill per claim for A9541? Based on 106 providers billing this code nationally.

Median

$27.26

Average

$54.90

Std Dev

$70.83

Max

$308.57

Percentile Distribution (Cost per Claim)

p10
$0.83
p25
$6.83
Median
$27.26
p75
$61.57
p90
$165.84
p95
$212.47
p99
$300.70

50% of providers bill between $6.83 and $61.57 per claim for this code.

90% bill between $0.83 and $165.84.

Top 1% bill above $300.70.

About This Procedure

HCPCS code A9541 was billed by 168 providers across 29K claims, totaling $760K in Medicaid payments from 2018–2024. This code was used for 26K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$27.26

Providers Billing

106

National Spending

$760K

Avg/Median Ratio

2.01×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A9541

#ProviderTotal Paid
11972004489$130K
2Uofl Health-louisville Inc

Louisville, KY · Psychiatric Hospital

$58K
3Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$50K
4Charleston Area Medical Center Inc

Charleston, WV · General Acute Care Hospital

$43K
5St Lukes Roosevelt Hospital Center

New York, NY · Case Management

$42K
6Riverside University Health Systems - Medical Center

Moreno Valley, CA · General Acute Care Hospital

$32K
7University Of Kentucky

Lexington, KY · General Acute Care Hospital

$23K
8Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$23K
9Beverly Radiology Medical Group Iii

Los Angeles, CA · Radiology, Diagnostic Radiology

$21K
101184606600$21K
11Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$20K
121851352348$20K
13Owensboro Health Inc

Owensboro, KY · General Acute Care Hospital

$20K
141538244918$20K
15Stanford Health Care

Stanford, CA · General Acute Care Hospital

$17K
16Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$16K
17Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$15K
18Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$14K
19The Cooper Health System

Camden, NJ · General Acute Care Hospital

$14K
20Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$12K

Showing top 20 of 168 providers billing this code