A9561
HCPCS Procedure Code
HCPCS code A9561 is the #7,225 most-billed Medicaid procedure code, with $24K in payments across 3K claims from 2018–2024. The national median cost per claim is $11.18. Costs vary widely — the 90th percentile is $66.21 per claim, 5.9× the median.
Total Paid
$24K
0.00% of all spending
Total Claims
3K
Providers
19
Avg Cost/Claim
$9
National Cost Distribution
How much do providers bill per claim for A9561? Based on 12 providers billing this code nationally.
Median
$11.18
Average
$26.77
Std Dev
$30.94
Max
$96.01
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.10 and $40.53 per claim for this code.
90% bill between $0.64 and $66.21.
Top 1% bill above $92.86.
About This Procedure
HCPCS code A9561 was billed by 19 providers across 3K claims, totaling $24K in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$11.18
Providers Billing
12
National Spending
$24K
Avg/Median Ratio
2.39×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for A9561
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1366459570 | $7K |
| 2 | 1396790499 | $5K |
| 3 | 1184606600 | $4K |
| 4 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $3K |
| 5 | 1699704254 | $3K |
| 6 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $387 |
| 7 | 1780653618 | $379 |
| 8 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $303 |
| 9 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $232 |
| 10 | Newark Beth Israel Medical Center Inc Newark, NJ · General Acute Care Hospital | $217 |
| 11 | 1073518007 | $136 |
| 12 | The Queens Medical Center Honolulu, HI · Psychiatric Unit | $30 |
| 13 | 1598875460 | $0 |
| 14 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $0 |
| 15 | Spartanburg Medical Center Spartanburg, SC · Ambulance | $0 |
| 16 | Dallas County Hospital District Dallas, TX · Clinic/Center, Ambulatory Surgical | $0 |
| 17 | 1639111057 | $0 |
| 18 | Yuma Regional Medical Center Yuma, AZ · General Acute Care Hospital | $0 |
| 19 | Inova Health Care Services Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder | $0 |
Showing top 19 of 19 providers billing this code